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Adalimumab induces and maintains remission in severe, resistant paediatric Crohn disease.

Crohn disease (CD) most often manifests in late adolescence or early adulthood; approximately 4% of CD cases are diagnosed before the age of 5 years (1). Complications of CD in children include growth failure, bone demineralization, and delayed sexual development (2). CD is often poorly responsive to corticosteroids and immunomodulators. Patients who are intolerant to conventional treatments or who have more severe or refractory disease may show a response to biological therapies. Infliximab (Remicade; Centocor, Malvern, PA) is an intravenously administered tumour necrosis factor (TNF) antagonist indicated for the treatment of CD in adults and children who have had an inadequate response to conventional therapy (3). Adalimumab (Humira; Abbott Laboratories, Abbott Park, IL) is a fully human immunoglobulin G1 monoclonal antibody to TNF that is administered subcutaneously and is indicated for use in adults with CD who have had an inadequate response to conventional therapy or infliximab or are intolerant of infliximab (4). However, clinical trial experience with adalimumab in CD is limited to adults (5). A search of the biomedical literature identified 1 published case report of adalimumab treatment of an adolescent (6). This report describes the administration of adalimumab in a 5-yearold male patient with severe, refractory CD.