Work

Corticosteroids Can Be Used to Decrease Antidrug Antibodies in Pediatric Patients With Inflammatory Bowel Disease

Year: 2021

Type: article

Abstract: To the Editors, We read the article by Colman et al with great interest.1 This group described the benefit that the addition of immunomodulators (IMs) had on decreasing antidrug antibodies (ADAs) in patients on antitumor necrosis factor (anti-TNF) monotherapy. This study is the first to demonstrate that adding IMs can reduce ADAs in pediatric IBD, but it is important to note there is a small but appreciable increased risk of development of lymphoma, specifically hepatosplenic T-cell lymphoma in patients on combination therapy with IM and anti-TNF therapy.2 We report our center’s experience with an alternative strategy using systemic steroids to decrease ADAs in our pediatric IBD patients. Farrel et al reported systemic steroid premedication could reduce ADA levels, demonstrating patients receiving hydrocortisone premedications prior to anti-TNF infusions had lower ADA levels at the 8-week and 16-week mark following therapy initiation as compared with control groups.3 To date, similar results have not been reported in a pediatric cohort.

Source: Inflammatory Bowel Diseases

DOI: 10.1093/ibd/izab182