Biologics in the management of pediatric inflammatory bowel disease:When and what to choose  

作　　者：Arghya Samanta Anshu Srivastava 

机构地区：[1]Department of Pediatric Gastroenterology,Sanjay Gandhi Postgraduate Institute of Medical Sciences,Lucknow 226014,Uttar Pradesh,India

出　　处：《World Journal of Clinical Pediatrics》2025年第1期21-45,共25页世界临床儿科杂志（英文）

摘　　要：Pediatric inflammatory bowel disease(PIBD)is a chronic inflammatory disorder of the gastrointestinal tract,with rising global incidence and prevalence.Over the past two decades,biologics have added to the therapeutic armamentarium and revolutionized the approach to treatment of inflammatory bowel disease.The available biologics include monoclonal antibodies which target inflammatory cytokines(anti-tumor necrosis factor alpha,anti-interleukin 12/23)or recruitment of leucocytes to the gastrointestinal tract(anti-alpha4beta7 integrin)and small molecules(Janus kinase inhibitors,sphingosine 1-phosphate-inhibitors)which modify the proinflammatory signaling.Considering their potential disease-modifying ability,recent pediatric guidelines from the West have advocated upfront use of biologics in appropriate clinical scenarios as a top-down approach rather than the conventional step-up approach.Although real-world studies are available regarding the clinical efficacy of biologics in PIBD,there is paucity of long-term outcome and safety data in children.Also,little information is available about the best approach in the newly industrialized-developing countries where PIBD is rising but at the same time,infections are prevalent and resources are limited.In this review,we summarize the efficacy and safety profile of biologics and small molecule drugs and discuss the challenges in the management of PIBD,especially in the developing world,and future directions.

关 键 词：BIOLOGICS CHILDREN Inflammatory bowel disease Therapeutic drug monitoring Dual biologic 

分 类 号：R725.7[医药卫生—儿科]