High anti-TNFα Concentrations are Not Associated With More Adverse Events in Pediatric Inflammatory Bowel Disease.

Abstract

ABSTRACT\nAnti-tumor necrosis factor alpha (anti-TNFα) therapy is commonly used to treat refractory pediatric inflammatory bowel disease (IBD) and carry risks for adverse events. We aimed to assess the relationship between anti-TNFα trough concentrations (TC) and adverse events rate among pediatric patients with IBD. The medical records of pediatric patients with IBD who were treated with anti-TNFα agents from 2015 to 2020 and had sequential monitoring of TC were reviewed retrospectively for the presence of adverse events. The study cohort included 135 eligible patients, [59 (43.7%) female, mean age at diagnosis 12.9 (±3) years, 111 (82.2%) Crohn s disease] who had 1589 measurements of TCs [1037 (63%) infliximab]. During a median follow-up period of 1.7\u200ayears (IQR 1.1-2.7), we recorded 156 adverse events in 50 patients (37%). Higher TCs were not associated with higher rate of anti-TNFα related adverse events whereas these events (excluding increase in liver transaminases) were associated with younger age.