Biological therapy in pediatric age

Penagini, Francesca; Cococcioni, Lucia; Pozzi, Elena; Dilillo, Dario; Rendo, Giulia; Mantegazza, Cecilia; Zuccotti, Gian Vincenzo

doi:10.1016/j.phrs.2020.105120

Cited by 11 publications

(18 citation statements)

References 190 publications

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“…As stated previously, approximately 50% of patients will lose their response to infliximab within 5 years [11]. One reason a biologic may fail is due to the development of antibodies to the medication.…”

Section: Geneticsmentioning

confidence: 92%

“…Lastly, there are biologics which have been shown to be effective in both inducing and maintaining remission of pediatric IBD [3,11]. Infliximab, an anti-TNF, has been shown to be effective in inducting and maintaining remission of CD and UC in pediatric patients [11]. However, this medication is not without risk.…”

Section: Maintenancementioning

confidence: 99%

“…However, this medication is not without risk. The main adverse effects include increased susceptibility to infection, development of antibodies to infliximab, and acute infusion reactions [11]. Interestingly, children with very early onset IBD are more likely to fail treatment with infliximab due to adverse events.…”

Section: Maintenancementioning

confidence: 99%

“…Interestingly, children with very early onset IBD are more likely to fail treatment with infliximab due to adverse events. Regardless of age, it is known that approximately 50% of patients will lose their response to infliximab within 5 years [11]. Adalimumab, a fully humanized anti-TNF, was developed with this in mind.…”

Section: Maintenancementioning

confidence: 99%

“…However, it lacks placebo control trials in pediatric IBD. Retrospective studies suggest that adalimumab should be considered as second-line therapy for pediatric patients that fail infliximab [11]. Other biologics such as golimumab, vedolizumab, and ustekinumab are also available but are rarely used in children due to the lack of evidence supporting their use [11].…”

Section: Maintenancementioning

confidence: 99%

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Pediatric Inflammatory Bowel Disease

Rotondo-Trivette

Michail

2021

Asp J Pediatrics Child Health

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Inflammatory bowel disease is an important pediatric disease, with as many as 25% of cases presenting during childhood. In this article, we review the types, etiology epidemiology, presentation, diagnosis, and management of pediatric inflammatory bowel disease. We also highlight the unique aspects of pediatric-onset inflammatory bowel disease versus adult-onset and future directions in this field, such as the use of genetic studies and ultrasound for the management of pediatric patients with inflammatory bowel disease.

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Section: Geneticsmentioning

confidence: 92%

Section: Maintenancementioning

confidence: 99%

Section: Maintenancementioning

confidence: 99%

Section: Maintenancementioning

confidence: 99%

Section: Maintenancementioning

confidence: 99%

See 3 more Smart Citations

Pediatric Inflammatory Bowel Disease

Rotondo-Trivette

Michail

2021

Asp J Pediatrics Child Health

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Liver enzyme profiles after initiating biological treatment in children with inflammatory bowel diseases

Räisänen,

Nikkonen,

Kolho

2024

J. pediatr. gastroenterol. nutr.

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ObjectivesBiological treatments (BTs) are essential in managing pediatric inflammatory bowel diseases (PIBDs). Elevated liver enzymes sometimes succeed BT, yet elucidating studies are scarce. We addressed liver biochemistry after introducing BT and searched for their determinants.MethodsWe identified PIBD patients receiving infliximab, adalimumab, vedolizumab, or ustekinumab at the Children's Hospital, University of Helsinki, Finland, in 2000–2023, and followed their alanine transaminase (ALT) and γ‐glutamyl transpeptidase (GT) levels for 24 months. ALT was categorized based on the age‐ and sex‐specific upper limit of normal. We disregarded 46 patients with underlying primary sclerosing cholangitis with/without autoimmune hepatitis (AIH), pretreatment AIH diagnosis, and elevated liver enzymes at the beginning of BT from the analyses.ResultsOf 618 BT episodes in 403 patients, 22.2% exhibited increased ALT or GT (ALT in 117, GT in 4, and both ALT/GT in 16 episodes). Of all ALT elevations (n = 133), 41.4% occurred within the first 3 months. ALT elevation was more common after infliximab (representing 59.5% of BTs) than other BTs (25.9% vs. 14.2%, adjusted odds ratio [OR]: 2.41, 95% confidence interval [CI]: 1.23–4.72). AIH followed 1.5% (n = 9) of BT episodes. Ninety‐five percent of ALT elevations resolved within 6 months. Antibiotic exposure (particularly to metronidazole) was associated with ALT elevation in general (adjusted OR: 5.76, 95% CI: 2.40–13.9) and short disease duration before starting BT with notable ALT elevation (adjusted OR: 1.10, 95% CI: 1.01–1.22).ConclusionsBenign ALT elevation is common within 3 months after starting BT (especially infliximab) and scarcely led to cessation of the treatment. AIH is a rare finding during the first year of BT.

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A pediatric case of moderate active ulcerative colitis successfully treated with vedolizumab in Japan

Ikeuchi

Kakiuchi

Ibi

et al. 2020

Clin J Gastroenterol

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Corticosteroids and biologics are used to treat moderate-to-severe active pediatric ulcerative colitis (UC); however, it is often difficult to continue administration because of systemic side reactions. Vedolizumab is considered to have few adverse effects due to its mechanism of action and it is expected to be used in children, but the long-term administration of vedolizumab to Japanese pediatric patients with UC has not been reported. We report a case of pediatric moderate active UC with anti-tumor necrosis factor-failure that was successfully treated with vedolizumab in Japan.

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Biological therapy in pediatric age

Cited by 11 publications

References 190 publications

Pediatric Inflammatory Bowel Disease

Pediatric Inflammatory Bowel Disease

Liver enzyme profiles after initiating biological treatment in children with inflammatory bowel diseases

A pediatric case of moderate active ulcerative colitis successfully treated with vedolizumab in Japan

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