Dose escalation of adalimumab as a strategy to overcome anti-drug antibodies: A case report of infantile-onset inflammatory bowel disease.
Adalimumab
Anti-drug antibodies
Case report
Dose escalation
Infantile-onset inflammatory bowel disease
Loss of response
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
14 Oct 2023
14 Oct 2023
Historique:
received:
07
06
2023
revised:
21
07
2023
accepted:
27
07
2023
medline:
31
10
2023
pubmed:
30
10
2023
entrez:
30
10
2023
Statut:
ppublish
Résumé
Treatment of infantile-onset inflammatory bowel disease (IO-IBD) is often challenging due to its aggressive disease course and failure of standard therapies with a need for biologics. Secondary loss of response is frequently caused by the production of anti-drug antibodies, a well-known problem in IBD patients on biologic treatment. We present a case of IO-IBD treated with therapeutic drug monitoring (TDM)-guided high-dose anti-tumor necrosis factor therapy, in which dose escalation monitoring was used as a strategy to overcome anti-drug antibodies. A 5-mo-old boy presented with a history of persistent hematochezia from the 10 TDM-guided high-dose ADA treatment as a monotherapy overcame ATA production. This strategy could be a good alternative to combination therapy, especially in very young patients.
Sections du résumé
BACKGROUND
BACKGROUND
Treatment of infantile-onset inflammatory bowel disease (IO-IBD) is often challenging due to its aggressive disease course and failure of standard therapies with a need for biologics. Secondary loss of response is frequently caused by the production of anti-drug antibodies, a well-known problem in IBD patients on biologic treatment. We present a case of IO-IBD treated with therapeutic drug monitoring (TDM)-guided high-dose anti-tumor necrosis factor therapy, in which dose escalation monitoring was used as a strategy to overcome anti-drug antibodies.
CASE SUMMARY
METHODS
A 5-mo-old boy presented with a history of persistent hematochezia from the 10
CONCLUSION
CONCLUSIONS
TDM-guided high-dose ADA treatment as a monotherapy overcame ATA production. This strategy could be a good alternative to combination therapy, especially in very young patients.
Identifiants
pubmed: 37900586
doi: 10.3748/wjg.v29.i38.5428
pmc: PMC10600799
doi:
Substances chimiques
Adalimumab
FYS6T7F842
Antibodies
0
Steroids
0
Infliximab
B72HH48FLU
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
5428-5434Informations de copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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