Biologic therapy in pediatric inflammatory bowel disease

The incidence of pediatric inflammatory bowel disease (IBD) has risen over the past several decades and therapeutic strategies continue to evolve. Many unique considerations must be taken into account when selecting the optimal therapy for a pediatric IBD patient, including the effect of therapy on growth parameters, the cummulative or long-term adverse effects of treatments, and the inherently longer duration of therapy give the young age at diagnosis. Biologic agents have been used to treat pediatric IBD for several decades. This chapter reviews the biologic agents currently used to treat this population, the indications for use in pediatric Crohn’s disease (CD) and ulcerative colitis (UC), outcomes associated with these medications, including impact on growth and bone health, and adverse events, specfically malignancy risks. Strategies and recommendations for vaccination of peidatric IBD patients receiving biologic therapy are also reviewed.