Infections and malignancies risks related to TNF-α-blocking agents in pediatric inflammatory bowel diseases

Patrizia Alvisi, Valeria Dipasquale, Arrigo Barabino, Stefano Martellossi, Erasmo Miele, Paolo Lionetti, Giuliano Lombardi, Salvatore Cucchiara, Giuliano Torre, Claudio Romano

Research output: Contribution to journalArticle

Abstract

Introduction: Tumor necrosis factor-α (TNF-α)-blocking agents are drugs approved for the treatment of inflammatory bowel diseases (IBDs). Infliximab and adalimumab are approved for the treatment of IBD in the pediatric setting with the improvement of therapeutic management. Biological agents, also in the pediatric population, can be administered either alone or in combination with immunomodulators. Their use has raised safety concerns regarding the risk of infections and malignancies. Areas covered: A broad review of the safety concerns for the use of anti-TNF-α drugs in children with IBD was performed, and information regarding the risk of infections and malignancies were updated, also in comparison with the safety of traditional drugs such as steroids and/or immunosuppressants. Expert commentary: Anti-TNF-α drugs have shown favorable safety profiles, and adalimumab treatment is associated with lower immunogenicity compared with infliximab. Heightened awareness and vigilant surveillance leading to prompt diagnosis and treatment are important for optimal management.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalExpert Review of Gastroenterology and Hepatology
DOIs
Publication statusE-pub ahead of print - Sep 6 2019

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Inflammatory Bowel Diseases
Tumor Necrosis Factor-alpha
Pediatrics
Safety
Infection
Neoplasms
Pharmaceutical Preparations
Therapeutics
Immunologic Factors
Biological Factors
Immunosuppressive Agents
Steroids
Population
Adalimumab
Infliximab

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Infections and malignancies risks related to TNF-α-blocking agents in pediatric inflammatory bowel diseases. / Alvisi, Patrizia; Dipasquale, Valeria; Barabino, Arrigo; Martellossi, Stefano; Miele, Erasmo; Lionetti, Paolo; Lombardi, Giuliano; Cucchiara, Salvatore; Torre, Giuliano; Romano, Claudio.

In: Expert Review of Gastroenterology and Hepatology, 06.09.2019, p. 1-5.

Research output: Contribution to journalArticle

Alvisi, Patrizia ; Dipasquale, Valeria ; Barabino, Arrigo ; Martellossi, Stefano ; Miele, Erasmo ; Lionetti, Paolo ; Lombardi, Giuliano ; Cucchiara, Salvatore ; Torre, Giuliano ; Romano, Claudio. / Infections and malignancies risks related to TNF-α-blocking agents in pediatric inflammatory bowel diseases. In: Expert Review of Gastroenterology and Hepatology. 2019 ; pp. 1-5.
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AU - Barabino, Arrigo

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AU - Miele, Erasmo

AU - Lionetti, Paolo

AU - Lombardi, Giuliano

AU - Cucchiara, Salvatore

AU - Torre, Giuliano

AU - Romano, Claudio

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AB - Introduction: Tumor necrosis factor-α (TNF-α)-blocking agents are drugs approved for the treatment of inflammatory bowel diseases (IBDs). Infliximab and adalimumab are approved for the treatment of IBD in the pediatric setting with the improvement of therapeutic management. Biological agents, also in the pediatric population, can be administered either alone or in combination with immunomodulators. Their use has raised safety concerns regarding the risk of infections and malignancies. Areas covered: A broad review of the safety concerns for the use of anti-TNF-α drugs in children with IBD was performed, and information regarding the risk of infections and malignancies were updated, also in comparison with the safety of traditional drugs such as steroids and/or immunosuppressants. Expert commentary: Anti-TNF-α drugs have shown favorable safety profiles, and adalimumab treatment is associated with lower immunogenicity compared with infliximab. Heightened awareness and vigilant surveillance leading to prompt diagnosis and treatment are important for optimal management.

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