Managing pediatric Crohn's disease: recent insights.

Standard of care therapy for moderate-to-severe pediatric Crohn's disease now entails precision dosing of anti-TNF therapy with periodic reassessment of bowel inflammation. The role of dietary modification continues to evolve. Current and future efforts need to be directed to elucidating ways to predict response to anti-TNF therapy and quickly changing to agents with other mechanisms of action when needed. Inordinate regulatory delays in approval of new therapies approved for adults continues to handicap pediatric clinicians and frequently limits their treatment choices, or forces them to give medications 'off label.' Only a concerted effort by clinicians, pharma, and regulators will improve this situation.