Reversal of Immunogenicity in Pediatric Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Medications.
10.5223/pghn.2018.21.4.329
- Author:
Elise KANG
1
;
Ali KHALILI
;
Judy SPLAWSKI
;
Thomas J SFERRA
;
Jonathan MOSES
Author Information
1. Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States. jonathan.moses@uhhospitals.org
- Publication Type:Case Report
- Keywords:
Child;
Biological products;
Antibodies
- MeSH:
Antibodies;
Biological Products;
Child;
Electrophoretic Mobility Shift Assay;
Humans;
Inflammatory Bowel Diseases*;
Necrosis*
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2018;21(4):329-335
- CountryRepublic of Korea
- Language:English
-
Abstract:
Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator.
