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Benefits and Risks of Combining Anti-tumor Necrosis Factor with Immunomodulator Therapy in Pediatric Inflammatory Bowel Disease
- Source :
- Inflammatory Bowel Diseases, 21(4), 951-961. Oxford University Press
- Publication Year :
- 2015
- Publisher :
- Oxford University Press, 2015.
-
Abstract
- Since the introduction of anti-tumor necrosis factor (TNF) therapy as treatment of inflammatory bowel disease (IBD), care of pediatric and adult patients with IBD has significantly improved. To further improve treatment efficacy and durability, multiple trials have compared the efficacy of combination therapy, using anti-TNF therapy combined with an immunomodulator (a thiopurine or methotrexate), with that of anti-TNF monotherapy with contradicting results. The safety of combined therapy has been questioned after several reported cases of hepatosplenic T-cell lymphoma in young patients with IBD so treated. Physicians prescribing anti-TNF therapy to patients with IBD are required to weigh the benefits of combined therapy with its risks. To inform physicians treating children with IBD of these benefits and risks, we reviewed studies in pediatric and adult patients with IBD comparing efficacy, durability, and/or safety of combined therapy with anti-TNF monotherapy.
- Subjects :
- medicine.medical_specialty
Adolescent
Combination therapy
Risk Assessment
Inflammatory bowel disease
Immunomodulation
Internal medicine
medicine
Humans
Immunology and Allergy
Combined Modality Therapy
Child
Thiopurine methyltransferase
biology
Tumor Necrosis Factor-alpha
business.industry
Gastroenterology
Inflammatory Bowel Diseases
medicine.disease
digestive system diseases
Lymphoma
Immunology
biology.protein
Tumor necrosis factor alpha
Methotrexate
business
Risk assessment
medicine.drug
Subjects
Details
- ISSN :
- 15364844 and 10780998
- Volume :
- 21
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Inflammatory Bowel Diseases
- Accession number :
- edsair.doi.dedup.....b769aaeef339ccc4dcb3b76d1b6bafe7