Therapeutic drug monitoring of anti-TNF therapy in children with inflammatory bowel disease.

Although TDM is not yet widely used in pediatric IBD, the available literature suggests it to be a promising tool, especially in patients with LOR to anti-TNF. There is increasing evidence that also in children, higher anti-TNF drug levels are associated with sustained response, and likewise low or undetectable trough levels increase the likelihood of LOR. TDM-based treat to target strategies are being designed in adult studies, but more prospective studies also in pediatric IBD populations looking at the role of proactive testing are needed.