RT Journal Article
T1 Proactive monitoring of anti-TNF agents improves follow-up of paediatric patients with Crohn disease
T2 La monitorización proactiva de niveles de anti-TNF mejora el seguimiento de los pacientes pediátricos con enfermedad de Crohn.
A1 Azor, Begona Rodriguez
A1 Martin-Masot, Rafael
A1 Khialani, Anita Dayaldasani
A1 Fernandez-Martin, Jesus Maria
A1 Fernandez, Carmen Gallego
A1 Navas-Lopez, Victor Manuel
K1 Paediatric Crohn disease
K1 Inflammatory bowel disease
K1 Therapeutic drug monitoring
K1 Infliximab
K1 Adalimumab
K1 Inflammatory-bowel-disease
K1 Adalimumab
K1 Therapy
K1 Experience
K1 Moderate
K1 Outcomes
K1 Spain
AB Introduction and aims: The incidence of paediatric inflammatory bowel disease has increased in recent decades. The aim of the present study was to evaluate the role of proactive and serial monitoring of tumour necrosis factor (TNF) inhibitor levels to maintain clinical remission and mucosal healing in the follow-up of paediatric patients with Crohn disease (CD).Method: Prospective study that included all patients diagnosed with CD and treated with adali-mumab or infliximab between May 2015 and November 2020 who underwent serial and proactive monitoring of TNF inhibitor levels.Results: The study included 30 patients, 21 male (70%). The mean age at diagnosis was 11.3 years (SD, 2.0), the mean age at initiation of TNF inhibitors was 12.6 years (SD, 1.9) with a mean duration of follow-up of 27.1 +/- 9.1 months. Clinical remission was defined as a weighted Pediatric Crohn's Disease Activity Index (wPCDAI) of less than 12.5 and mucosal healing as a Mucosal Inflammation Non-invasive Index (MINI) of less than 8. During the follow-up, patients were in clinical remission in 87.1% of the visits, presented with mild disease in 11.4% and with moderate disease in 1.5%, and mucosal healing was assumed in 83% of the visits. The rates of clinical remission and mucosal healing at 1, 2, and 3 years of follow-up were 83.3%, 95.8%, 92.8%, and 86.7%, 87.5% and 85.7%, respectively. Conclusions: Proactive and serial monitoring of serum TNF inhibitor levels may make it possible for patients to maintain clinical remission and mucosal healing in the maintenance phase, with individualised optimization of the required dosage and minimization of secondary loss of response.(c) 2022 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
PB Ediciones Doyma
SN 1695-4033
YR 2023
FD 2023-03-01
LK http://hdl.handle.net/10668/21963
UL http://hdl.handle.net/10668/21963
LA en
NO Rodríguez Azor B, Martín-Masot R, Dayaldasani Khialani A, Fernández-Martín JM, Gallego Fernández C, Navas-López VM. Proactive monitoring of anti-TNF agents improves follow-up of paediatric patients with Crohn disease. An Pediatr (Engl Ed). 2023 Mar;98(3):165-174
DS RISalud
RD Apr 8, 2025