Treatment of Inflammatory Bowel Disease with Biologics

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successfully tapered off corticosteroids and maintained on ustekinumab therapy.
More data is needed to determine the safety and efficacy of ustekinumab in pediatric
CD, and a randomized double-blind pharmacokinetic study of ustekinumab in mod-
erately to severely active pediatric CD is ongoing (ClinicalTrials.gov identifier:
NCT02968108).
The above paragraphs demonstrate the efficacy of anti-TNF therapy in pediatric
IBD for induction and maintenance of remission and for improving linear growth
and bone health, as well as review the emerging evidence for use of newer biologics
vedolizumab and ustekinumab in this patient population. There have been numer-
ous advances in the understanding and use of biologic therapy in pediatric IBD,
which have led to improved patient outcomes. However, significant knowledge gaps
still exist, including better identification of patients who would most benefit from
early biologic therapy and those who have more risks associated with this therapy
and direct comparison of the effectiveness of monotherapy versus combination ther-
apy in pediatric patients. Additionally, cost of therapy, access to infusion centers,
and safety of home infusions are additional concerns, and some of these factors may
present barriers to care. Biologic therapy will continue to play an increasing role in
the treatment of pediatric inflammatory bowel disease, but additional research of
these agents remains necessary to help guide patients and their families to optimal
therapeutic decisions.

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11 Biologic Therapy in Pediatric Inflammatory Bowel Disease