Updates in Healthcare Maintenance and Monitoring of Children with Inflammatory Bowel Disease in the Era of Biologic Therapies

Abstract

As the therapeutic armamentarium for the management of pediatric inflammatory bowel disease (IBD) expands, it is increasingly challenging for pediatric gastroenterologists and pediatric primary care providers to stay abreast of the available therapies and the associated side effects, required monitoring, and specific health maintenance needs for these patients. Here, we review the currently available therapies and general treatment strategies for the management of pediatric IBD, along with clinical considerations in the context of general pediatric care. The number of therapies for the management of IBD has grown rapidly in recent years. While pediatric providers have become adept with the use of anti-tumor necrosis factor-alpha therapies, and large safety registries have helped us understand the risks of these biologic agents, there is much left to learn about the pediatric use of newer therapies, such as vedolizumab, ustekinumab, and tofacitinib. Biologic therapies and other targeted anti-inflammatory therapies are increasingly used in children with IBD. Pediatric primary care providers and pediatric gastroenterologists must be aware of the risks, benefits, and additional implications of these therapies. Vaccination strategies, recognition and management of routine or opportunistic infections, assessment of rashes, and cancer screening represent areas of particular importance in these children.