Golimumab in adolescents with Crohn’s disease refractory to previous tumor necrosis factor antibody
Abstract Background Inducing and maintaining clinical remission in children with Crohn’s disease (CD) is associated with treatment with antibody to tumor necrosis factor (TNF)-α such as infliximab or adalimumab. In the treatment of paediatric CD, there are no data about the use of a third introduced subcutaneous TNF-antibody, golimumab, Methods We evaluated the efficacy of golimumab for adolescents with moderate/severe CD. Retrospective analyses were done in all 7 (5 girls) adolescents who received golimumab at a median age of 17 years for a median of 7.2 months. Paediatric Crohn’s disease activity index (PCDAI), full blood count, inflammatory markers, use of corticosteroids and adverse events were recorded. Results With golimumab, 5 of the 7 children were PCDAI responders and 2 entered remission (PCDAI<10). There was a significant increase in haematocrit after 2 weeks, faecal calprotectin was significantly reduced after 4 weeks compared to baseline. Out of five children, steroid withdrawal was possible in one and steroid reduction in two cases. There were no serious side effects. Conclusion With moderate/severe CD, golimumab induced and maintained clinical response. The majority of children were PCDAI responders, in most steroid sparing was possible. Golimumab might be an effective rescue therapy in refractory CD.