Department of Paediatrics, Monash University, Clayton, VIC 3800, Australia.
Gastroenterol Res Pract. 2011;2011:287574. doi: 10.1155/2011/287574. Epub 2011 Nov 17.
Crohn's disease affects increasing numbers of children worldwide. Generally, childhood-onset disease runs a more severe course than in adults and has a greater impact on quality of life. Therapy in children must take account of a different set of risks for toxicity compared to adults, but also to their longevity. Biologic drugs present remarkable advantages in terms of disease control for children, especially in those whose disease cannot be controlled with conventional therapies, but their long-term risks are still being assessed. Data regarding biologic use in children is limited and mostly amounts to case series, but results have been promising, both in terms of controlling disease activity and improving growth parameters. Adverse reactions are infrequent in the short term, but loss of response is a long-term problem, particularly in children. More information is needed about very long term risks. Infliximab and adalimumab are the most studied agents in children, while there is relatively limited data on certolizumab and natalizumab. Further collection of data on these agents is still needed, but this should not restrict access to these agents for children in whom no other agent is effective.
克罗恩病在全球范围内影响着越来越多的儿童。一般来说，儿童发病的疾病比成人更严重，对生活质量的影响更大。儿童的治疗必须考虑到与成人相比毒性的风险不同，但也要考虑到他们的寿命。生物药物在控制儿童疾病方面具有显著优势，特别是在那些不能通过常规治疗控制疾病的儿童中，但它们的长期风险仍在评估中。关于儿童使用生物制剂的数据有限，主要是病例系列，但结果令人鼓舞，无论是在控制疾病活动还是改善生长参数方面。短期不良反应罕见，但长期来看，失去反应是一个问题，尤其是在儿童中。还需要更多关于非常长期风险的信息。英夫利昔单抗和阿达木单抗是在儿童中研究最多的药物，而关于certolizumab 和natalizumab 的数据相对有限。仍需要进一步收集这些药物的数据，但这不应限制对其他药物无效的儿童使用这些药物。
