The Treatment of Pediatric Inflammatory Bowel Disease with Biologic Therapies.
The Treatment of Pediatric Inflammatory Bowel Disease with Biologic Therapies.
复制标题
DOI：
10.1007/s11894-020-00773-3
复制
发表时间：
2020-06-15
影响因子：
--
通讯作者：
Kelsen JR
中科院分区：
文献类型：
--
作者：
Conrad MA;Kelsen JR
用于治疗炎症性肠病 (IBD) 的生物制剂已经彻底改变了儿科人群的治疗目标。我们回顾了用于治疗 IBD 的生物制剂，强调了儿童患者选择、剂量考虑和治疗药物监测的重要性。英夫利昔单抗是公认的治疗克罗恩病和溃疡性结肠炎的安全有效的药物。剂量递增策略和治疗药物监测都增加了对抗 TNFα 疗法产生反应的可能性。维多珠单抗和优特克单抗治疗儿科 IBD 的早期实际经验显示出有希望的结果，包括与成人相当的临床反应率，但将它们用作一线疗法的数据有限。生物疗法改善了儿科 IBD 的治疗效果，包括实现粘膜愈合以及改善生长和青春期发育。治疗药物监测可提高抗 TNFα 疗法产生反应的可能性，但需要对维多珠单抗和乌特克单抗进行进一步研究。
Biologics for the treatment of inflammatory bowel disease (IBD) have been transformative to the therapeutic goals in the pediatric population. We review the biologics used to treat IBD, highlighting the importance of patient selection, dosing considerations, and therapeutic drug monitoring in children. Infliximab is well-established as a safe and efficacious therapy for Crohn disease and ulcerative colitis. Both dose escalation strategies and therapeutic drug monitoring increase the likelihood of response to anti-TNFα therapies. Early real-world experience of vedolizumab and ustekinumab in pediatric IBD shows promising results, including clinical response rates comparable to what is seen in adults, but there are limited data using them as first-line therapies. Biologic therapies have improved outcomes in pediatric IBD, including achieving mucosal healing as well as improved growth and pubertal development. Therapeutic drug monitoring improves likelihood of response to anti-TNFα therapies, but further studies for vedolizumab and ustekinumab are necessary.