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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
241
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
191
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
209
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

483
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Updated: Jan 14, 2026

Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
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Real-World Tocilizumab Use in Pediatric Inpatients.

Gideon A Stitt1, Mark W Hall2, Mary Ann Diliberto3

  • 1Division of Clinical Pharmacology (GAS), Department of Pediatrics, University of Utah, Salt Lake City, UT.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|October 20, 2025
PubMed
Summary
This summary is machine-generated.

Tocilizumab (TCZ) is used for various pediatric conditions, with transaminitis being common. Extracorporeal support and oncologic diagnosis are linked to mortality, but active infection during TCZ use was not.

Keywords:
cytokinesevidence-based medicineinterleukin-6patient safetypharmacology

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Area of Science:

  • Pediatric Rheumatology
  • Pediatric Hematology-Oncology
  • Pediatric Critical Care

Background:

  • Tocilizumab (TCZ) is an interleukin-6 receptor inhibitor used in various pediatric inflammatory conditions.
  • Limited data exists on TCZ utilization patterns, safety, and outcomes in hospitalized pediatric patients.

Purpose of the Study:

  • To quantify TCZ use in pediatric inpatients.
  • To explore the safety and clinical outcomes associated with TCZ administration in this population.

Main Methods:

  • Retrospective cohort study of pediatric inpatients receiving intravenous TCZ from January 2016 to May 2021.
  • Data collection included demographics, indications, dosing, safety events (0-7 days post-TCZ), extracorporeal support (ES), concurrent infection, and survival.
  • Exploratory analyses identified factors associated with mortality.

Main Results:

  • 103 TCZ courses (87 patients) were analyzed; median age was 14 years.
  • Common indications: cytokine release syndrome (CRS; 56%), autoimmune disease (27%), graft-versus-host disease (GVHD; 5%), COVID-19 (4%).
  • Transaminitis (ALT/AST >3x ULN) occurred in 53-60% of courses. Survival to discharge was 83%. ES, oncologic diagnosis, and post-TCZ infection were associated with mortality.

Conclusions:

  • TCZ is utilized for diverse pediatric inpatient indications, primarily CRS.
  • New-onset transaminitis is frequent post-TCZ. Mortality risk factors are likely influenced by underlying illness severity.
  • TCZ administration during active infection was not independently linked to increased mortality.