Reversal of Immunogenicity in Pediatric Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Medications

Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immun...

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Bibliographic Details
Published inPediatric gastroenterology, hepatology & nutrition Vol. 21; no. 4; pp. 329 - 335
Main Authors Kang, Elise, Khalili, Ali, Splawski, Judy, Sferra, Thomas J, Moses, Jonathan
Format Journal Article
LanguageEnglish
Published Korea (South) The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 01.10.2018
대한소아소화기영양학회
Subjects
Case Report
소아과학
Antibodies
Child
Biological products
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Summary:Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator.
ISSN:2234-8646
2234-8840
DOI:10.5223/pghn.2018.21.4.329