New drugs: Kids come first; Con: First adults, then children

✍ Scribed by M. Stephen Murphy

• Book ID: 102265075
• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 78 KB
• Volume: 13
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20179

✦ Synopsis

THE NEW ERA OF BIOLOGIC AGENTS

It seems that we may be entering an era of profound and rapid change in the treatment of inflammatory bowel disease (IBD). 1,2 Since the introduction of infliximab for the treatment of Crohn's disease (CD) in the 1990s an ever-expanding range of biologic agents has been developing. 3 Each new agent appears to offer therapeutic possibilities. In 2005 it was reported that 14 biologics had been approved by the US Food and Drug Administration (FDA), over 70 were being evaluated in clinical trials, and more than 1000 were in preclinical development. 4 If newly emerging agents are thought to have therapeutic potential in IBD, should we aim to rapidly evaluate them in children with a view to incorporating them into pediatric practice?

The biologics have real potential to cause harm. We currently possess a range of conventional treatments that despite their deficiencies are effective in many patients. They have the great advantage of having been in use for decades. We therefore have a wealth of information on them for risk/benefit analysis in decisions on therapy. The proper place for these new agents in pediatric IBD should emerge from carefully designed clinical trials. As a general rule, however, they should first be thoroughly evaluated in adult patients.