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Anti-Tumour Necrosis Factor Therapy for Paediatric Crohn's Disease: Improved Benefits Through Treatment Optimisation,

M A Cozijnsen1, J N Samsom2, L de Ridder3

  • 1Department of Paediatric Gastroenterology, Erasmus University Medical Centre-Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.

Paediatric Drugs
|October 29, 2017
PubMed

Insights

Anti-tumour necrosis factor-α (TNF-α) antibodies are effective for paediatric Crohn's disease (CD). New research improves treatment effectiveness, clarifies safety, and introduces cost-effective biosimilars for better paediatric CD management.

Area of Science:

  • Immunology
  • Gastroenterology
  • Pharmacology

Background:

  • Anti-tumour necrosis factor-α (TNF-α) therapies are crucial for managing paediatric Crohn's disease (CD).
  • Optimizing anti-TNF treatment effectiveness and safety is an ongoing research priority.
  • Understanding predictors of treatment response and long-term safety is essential for clinical practice.

Purpose of the Study:

  • To review recent advancements in anti-TNF antibody treatment for paediatric Crohn's disease.
  • To evaluate the accuracy of identified response predictors in this patient population.
  • To reassess the safety profile of anti-TNF therapies, particularly regarding malignancy risk.

Main Methods:

  • Literature review of recent studies on anti-TNF treatment in paediatric CD.
  • Analysis of data on predictors of anti-TNF treatment responsiveness.
  • Evaluation of safety data, including malignancy risk associated with combination therapies.
  • Assessment of clinical trial results for infliximab biosimilars.

Main Results:

  • Potential predictors for anti-TNF responsiveness exist, but their accuracy in paediatric CD requires further validation.
  • The increased malignancy risk previously associated with anti-TNF and thiopurine combination therapy may primarily be linked to thiopurine use.
  • Early data confirm the efficacy and safety equivalence of the infliximab biosimilar CT-P13 compared to the originator in CD patients.
  • Treatment effectiveness is improving, malignancy risk is lower than presumed, and costs are decreasing due to biosimilars.

Conclusions:

  • Anti-TNF antibody treatment is becoming more effective and safer for paediatric CD.
  • The introduction of infliximab biosimilars reduces treatment costs without compromising efficacy.
  • These advancements support a greater role for anti-TNF antibodies in the future management of paediatric Crohn's disease.

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