Pediatric Crohn’s Disease
What is Pediatric Crohn’s Disease?
Pediatric Crohn’s Disease refers to the onset of Crohn’s disease in children and young adults. Early onset of the disease is associated with an increased involvement of both the upper and lower GI tract in the disease.
Inflammation of the GI tract causes recurring “flares” of disease severity which are associated with abdominal pain, poor absorption of nutrition, diarrhea, nausea and rectal bleeding. The inflammation can cause strictures and malformation of the GI tract which may require corrective surgery. Flares may recur over a period of weeks to years, depending on the specific individual.
Some Quick Facts about Pediatric Crohn’s Disease
- About half of all Pediatric Crohn’s patients have inflammation of both the upper and lower GI tract
- The younger the age of onset for pediatric Crohn’s is, the more likely there is to be a family history of inflammatory bowel disease (IBD)
- Occurrence of Crohn’s disease in pediatric patients is associated with genetic mutations in both the innate and adaptive immune system
- The incidence of IBD in general, and Crohn’s in particular, has been broadly increasing over the last 50 years, particularly in the developed world, suggesting a role for the “sanitary hypothesis” – that is, while sanitary conditions improve, immune-mediated disease also increases
- Pediatric Crohn’s Disease is 2x more likely than ulcerative colitis in pediatric patients with inflammatory bowel disease
- There are over 50,000 total cases of pediatric IBD in North America and 4,500 new cases annually
More information on Pediatric Crohn’s Disease can be found at Cedars Sinai.
Symptoms of Crohn’s Disease
Symptoms of Pediatric Crohn’s Disease include:
- Abdominal pain
- Diarrhea, sometimes bloody
- Rectal bleeding
- Weight loss
- Delayed growth
- Joint pain
- Skin rashes
Disease symptoms may come and go with disease remission.
Disease progression may be associated with malformation of the gastrointestinal tract that requires surgery to ameliorate.
More information on Pediatric Crohn’s disease can be found in our Reference Literature.
Pediatric Crohn’s Disease Treatment Options
Disease “flares” are primarily treated with either corticosteroid or biological anti-inflammatory agents. Other agents may be used as maintenance therapy between flares.
Treatment is limited to off-label use of steroids (e.g. prednisone), local steroids targeting the distal GI tract only, and other anti-inflammatory treatments and second-line use of biologics.
Prednisone (steroid) Treatment
When changes in nutrition and lifestyle are inadequate to control Crohn’s disease flares, immediate treatment is often initiated with high doses of prednisone.
Prednisone is a steroid that helps to control the inflammation. However, steroids have a number of associated side effects, including causing high blood pressure, glucose intolerance, reduced bone mass, cataracts, decreased growth and increased risk of infections. Some of these side effects further exacerbate complications from the disease itself such as lack of growth. Because the prednisone can reach all areas of the body (systemically), all these side effects occur. Due to the severity of side effects, treatment is kept as minimal as possible.
Unfortunately, steroid use can also lead to steroid dependence, such that stopping treatment with the steroids results in immediate disease flare ups.
There are two FDA approved treatments for severe disease that have failed conventional (e.g., steroid) therapy. These treatments suppress specific inflammatory signaling in the body.
Both products are associated with BLACK BOX warnings for causing cancer (e.g., lymphoma) and increasing risk of life-threatening infection.
- Humira® (Adalimumab) is given as an injection once every two weeks.
- Remicade® (Infliximab) is given as a 2-hour intravenous infusion every 8 weeks at the physician’s office.
Where Soligenix Comes in
SGX203 is an alternative steroid anti-inflammatory treatment for Pediatric Crohn’s Disease flares. The active ingredient in SGX203 is beclomethasone dipropionate (BDP), a very well-characterized steroid that has a reduced ability to cross into the bloodstream.
By administering BDP as a 2-tablet system, with one tablet dissolving in the stomach and one in the lower intestine, a topical coating of BDP throughout the GI tract can be achieved, providing direct anti-inflammatory action where it is needed while reducing the penetration of the steroid to the bloodstream. This may reduce the toxicity of steroid treatment, while maintaining the steroid activity where it is needed.
Resources About Pediatric Crohn’s Disease
Information on Pediatric Crohn’s disease progression and treatment options is also available at the following sites:
Pediatric Crohn’s Disease Scientific Advisory Board
Our scientific advisory board for Pediatric Crohn’s disease has decades of experience in the biopharmaceutical industry, which includes unique expertise in developing orphan/rare disease therapies. All content on this page has been reviewed by our team of experts.
Meet the Pediatric Crohn’s disease scientific advisory board.