The Management Approach to the Adolescent IBD Patient: Health Maintenance and Medication Considerations

Vaccinations in Children and Adolescents Treated With Immune-Modifying Biologics: Update and Current Developments

“…According to EULAR (European League Against Rheumatism) recommendations, non-live vaccines can be administered to pediatric patients with rheumatic diseases using anti-TNFα therapy, as required by national vaccine guidelines 49 . All inactivated vaccines should be administered in patients with inflammatory bowel diseases (IBD) regardless of immunosuppressive therapy, as recommended by the Infectious Disease Society of America (IDSA) and the American Academy of Pediatrics 33,[50][51][52][53] . Most studies support the safety and immunogenicity of inactivated vaccines, especially in patients with low disease activity.…”

“…Patients, who do not mount a protective response, should be revaccinated following the standard HBV vaccine regimen (at months 0, 1 and 4-6) or an accelerated schedule (months 0, 1, and 2) 50 . According to a recent review, previously vaccinated adolescents with IBD, in which anti-HBs is not detectable, should receive a second 3-dose and/or a single high-concentration HBV vaccine (dose 40 mcg/ml) before rechecking antibody titers 51 . A prospective study of 100 children and young adults previously vaccinated against HBV and treated with infliximab for IBD, showed that infliximab dose, frequency of administration and duration of therapy as well as concomitant use of other immunomodulators did not affect duration of antibody response.…”

“…Treatment with anti-TNFα may also induce accelerated post-meningococcal C vaccine antibody waning, with the need of revaccination 54 . Due to increased risk of pneumonia and upper respiratory tract infections in pediatric patients on immunosuppressive therapies, pneumococcal and influenza vaccines are particularly recommended 51 . According to EULAR recommendations, annual non-live influenza vaccine should be considered in all pediatric patients with rheumatic diseases.…”

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

“…Pediatric inflammatory bowel diseases (IBD) are a group of chronic, immune-mediated diseases where multidisciplinary care is considered the standard of care (1)(2)(3)(4)(5)(6)(7). Multidisciplinary care for pediatric IBD includes traditional medical roles as well as psychosocial care, including but not limited to pediatric psychologists, social workers, and child life specialists (6,7).…”

Telemedicine and Integrated Multidisciplinary Care for Pediatric IBD Patients: A Review

“…While the composition of multidisciplinary pediatric IBD treatment teams vary across institutions, they typically include a combination of IBD gastroenterologists, advanced practice providers, nurses, surgeons, dieticians, psychologists, and social workers in collaborative treatment of the biological, psychological, and social needs of the patient and family throughout the course of the disease [ 22 ]. Research specifically examining integrated multidisciplinary treatment approaches within the IBD patient population demonstrates that early intervention and close follow-up from multidisciplinary providers are vital in achieving and maintaining remission [ 23 ], minimizing complications [ 24 ], identifying existing and acute psychosocial concerns [ 25 ] and reducing inpatient and outpatient healthcare costs associated with the disease [ 26 , 27 , 28 ].…”