Crohn disease (CD) is a chronic inflammatory bowel disease (IBD) characterized by periods of relapse and remission. In a genetically predisposed individual, environmental factors lead to a dysregulated adaptive immune response resulting in chronic intestinal inflammation and the potential long-term complications of intestinal stricture and perianal disease. (1) In pediatric CD, there is the additional complication of corticosteroid dependence, resulting in growth failure and significant psychosocial impact. (2) The need for surgical intervention in children is considerable also, with 5% requiring surgery at 1 year from diagnosis and 18% at 5 years. (3)

The clinical severity and location of disease often dictate what agents are chosen to treat CD, with the goal being to induce and then maintain long-term remission. Conventionally, 5-aminosalicylate (5-ASA) therapy, such as mesalamine, is used often for mild disease, although the evidence for this approach is not considered robust. (...

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