Benefits and Risks of Combining Anti-tumor Necrosis Factor with Immunomodulator Therapy in Pediatric Inflammatory Bowel Disease

被引：21

作者：

Cozijnsen, Martinus A. ^{[1
]}

Escher, Johanna C. ^{[1
]}

Griffiths, Anne ^{[2
]}

Turner, Dan ^{[3
]}

de Ridder, Lissy ^{[1
]}

机构：

[1] Sophia Childrens Univ Hosp, Erasmus Med Ctr, Pediat Gastroenterol, Rotterdam, Netherlands

[2] Hosp Sick Children, Pediat Gastroenterol, Toronto, ON M5G 1X8, Canada

[3] Hebrew Univ Jerusalem, Pediat Gastroenterol, Shaare Zedek Med Ctr, Jerusalem, Israel

来源：

INFLAMMATORY BOWEL DISEASES | 2015年 / 21卷 / 04期

关键词：

inflammatory bowel disease; pediatric; immunomodulators; biologic therapies; SEVERE CROHNS-DISEASE; SCHEDULED INFLIXIMAB MAINTENANCE; ULCERATIVE-COLITIS; COMBINATION THERAPY; CONSENSUS GUIDELINES; CLINICAL-RESPONSE; CENTER EXPERIENCE; ADULT PATIENTS; CO-TREATMENT; ADALIMUMAB;

D O I：

10.1097/MIB.0000000000000245

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Since the introduction of anti-tumor necrosis factor (TNF) therapy as treatment of inflammatory bowel disease (IBD), care of pediatric and adult patients with IBD has significantly improved. To further improve treatment efficacy and durability, multiple trials have compared the efficacy of combination therapy, using anti-TNF therapy combined with an immunomodulator (a thiopurine or methotrexate), with that of anti-TNF monotherapy with contradicting results. The safety of combined therapy has been questioned after several reported cases of hepatosplenic T-cell lymphoma in young patients with IBD so treated. Physicians prescribing anti-TNF therapy to patients with IBD are required to weigh the benefits of combined therapy with its risks. To inform physicians treating children with IBD of these benefits and risks, we reviewed studies in pediatric and adult patients with IBD comparing efficacy, durability, and/or safety of combined therapy with anti-TNF monotherapy.

引用

页码：951 / 961

页数：11

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