Facing Real-World Challenges of Immunogenicity in Pediatric Inflammatory Bowel Disease

Abstract

The advent of biological therapies drastically altered the landscape of inflammatory bowel disease (IBD) treatment, making long-term steroid-free remission possible for thousands of patients living with this chronic inflammatory condition that compromises the integrity of the gastrointestinal mucosa. Unfortunately, up to 65% of patients with IBD develop anti-drug antibodies to biologics (1). This is especially problematic for pediatrics, where treatment options are substantially more limited than for adult patients. Currently, only two biologics have approval from the United States (U.S.) Food and Drug Administration (FDA) for pediatric indications in IBD, anti-TNF-α agents infliximab (IFX), and adalimumab (ADM). The fear of losing these two agents to immunogenicity is very real for the providers and the families of the ~70,000 children affected by IBD in the U.S. (2).