Characteristics of biological therapy in pediatric patients with Crohn’s disease

Tárnok, András; Kiss, Zoltán; Kadenczki, Orsolya; Veres, Gábor

doi:10.1080/14712598.2019.1564034

Cited by 8 publications

(7 citation statements)

References 129 publications

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“…In recent years, biological therapies have begun to be used in the pediatric population, and these approaches currently play a key role in the management of several diseases. The management of PD has improved since the introduction of these therapies, reducing the number of surgical procedures and improving the quality of life of patients (9)(10)(11) .…”

Section: O R I G I N a L A R T I C L Ementioning

confidence: 99%

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Pediatric perianal Crohn´s disease behavior in the era of biologic therapy

Puente¹,

Góngora²,

Romero³

et al. 2023

Cir Pediatr

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Aim of the study. To describe perianal Crohn's disease behavior and the role of biological therapy in a sample of pediatric patients.Methods. A retrospective study of pediatric patients with Crohn's disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD.Results. Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received.Conclusions. CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.

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Section: O R I G I N a L A R T I C L Ementioning

confidence: 99%

“…Anti-TNFα treatment is currently recommended as induction therapy for children with active perianal fistulizing disease; when necessary, anti-TNFα may be combined with surgery (11) . We observed an increased risk for biological therapy in children with perianal findings.…”

Section: Use Of Biological Therapymentioning

confidence: 99%

Pediatric perianal Crohn´s disease behavior in the era of biologic therapy

Puente¹,

Góngora²,

Romero³

et al. 2023

Cir Pediatr

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“…En los últimos años, las terapias biológicas han empezado a emplearse en la población pediátrica, hasta el punto de que estos abordajes desempeñan actualmente un papel fundamental en el manejo de diversas enfermedades. El manejo de la EP ha mejorado desde la introducción de estas terapias, que han reducido el número de cirugías y mejorado la calidad de vida de los pacientes (9)(10)(11) .…”

Section: Introductionunclassified

Comportamiento de la afectación perianal en pacientes pediátricos con enfermedad de Crohn en la era de la terapia biológica

Puente¹,

Góngora²,

Romero³

et al. 2023

Cir Pediatr

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muestra de pacientes pediátricos.Métodos. Estudio retrospectivo de pacientes pediátricos con enfermedad de Crohn (EC) tratados en nuestro centro entre 2017 y 2021, con un seguimiento mínimo de seis meses. Los pacientes se dividieron en función de si tenían enfermedad perianal (EP) o no. Se compararon entre ambos grupos las características iniciales, la extensión de la enfermedad, el índice de retraso en el crecimiento, el índice de patrón agresivo, el empleo de terapia biológica y la necesidad de cirugía, entre otras variables. Se consideró un buen control de la EP una mejoría clínica o radiológica en los 6 últimos meses de seguimiento.Resultados. Se incluyeron 78 pacientes pediátricos con EC. La edad mediana en el momento del diagnóstico fue de 10,5 años, y el tiempo mediano de seguimiento fue de 3,8 años. El 64,1% de los pacientes eran varones. Del total, 15 (19,2%) tenían enfermedad perianal, de los cuales 10 presentaban hallazgos fistulizantes y 5 no fistulizantes. La EP estaba presente en el momento del diagnóstico en 8 pacientes, y el resto la desarrolló en una mediana de 1 año desde el diagnóstico. La EP se asoció con retraso en el crecimiento (p = 0,003), empleo de terapias biológicas (p = 0,005) y necesidad de una segunda línea de terapia biológica (p = 0,005). La mayoría de los pacientes (12/15, 80%) tuvieron un buen control de la EP con el tratamiento recibido.Conclusiones. Los pacientes de EC con EP parecen necesitar un tratamiento más agresivo, en el que las terapias biológicas desempeñan hoy en día un papel fundamental. Estos pacientes precisan de una estrecha evaluación nutricional que garantice su correcto crecimiento y desarrollo.

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“…While guidelines have been developed for the treatment of CD and UC populations, questions remain regarding the appropriate selection, monitoring, and switching rules for both biologic and biosimilar use in individual patients [4][5][6][7]. Based on disease severity at initial presentation, patients are started often on a biologic or combinations of biologics (i.e., agents with different mechanisms of action, such as combining an anti-TNF-α and an anti-integrin or anti-IL 12/23) instead of steroids and immunomodulators, especially in children [8][9][10][11]. In fact, higher rates of morbidity and mortality have been observed in patients treated with prolonged steroids compared to biologics [12].…”

Section: Introductionmentioning

confidence: 99%

Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

Parrish

2021

Gastroenterology Insights

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This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic mechanisms for inflammatory bowel diseases (IBD) in adult and pediatric patients. Since they are not identical to the originator or reference biologic agent, all biosimilars are not generically equivalent. However, in the US and other countries, they are considered therapeutically interchangeable if the manufacturer has demonstrated no clinically meaningful differences from the reference product. Comparisons of different clinical initiation and switching scenarios are discussed with reference to interchangeability, immunogenicity, nocebo effect, cost effectiveness, and time courses for discontinuation rates.

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Characteristics of biological therapy in pediatric patients with Crohn’s disease

Cited by 8 publications

References 129 publications

Pediatric perianal Crohn´s disease behavior in the era of biologic therapy

Pediatric perianal Crohn´s disease behavior in the era of biologic therapy

Comportamiento de la afectación perianal en pacientes pediátricos con enfermedad de Crohn en la era de la terapia biológica

Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary

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