{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:42:31Z","timestamp":1776400951821,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the study is to evaluate the efficacy of anti\u2010tumor necrosis factor (TNF)\u2010\u03b1 monotherapy versus combination anti\u2010TNF\u2010\u03b1 and immunosuppressive therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center, retrospective, observational study was conducted on inflammatory bowel disease (IBD) children. Patients with at least 6 months of follow\u2010up were enrolled and divided into two groups based on therapy. Combo group included children on combination anti\u2010TNF\u2010\u03b1 and immunosuppressant therapy; children undergoing anti\u2010TNF\u2010\u03b1 monotherapy were assigned to Mono group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and seventeen children were enrolled, of whom 74 (63.2%) were affected by Crohn's disease (CD) and 43 (36.8%) by ulcerative Colitis (UC) (median age at diagnosis: 11.6 years; range 2.1\u201316.9; M\/F: 56\/61). Eighty patients (68.4%) were included in combo group and 37 (31.6%) in mono group. The median follow\u2010up was 2.6 years (0.5\u201311.3). Twenty\u2010three patients out of 80 (28.7%) in Group 1 showed therapy failure compared with 21\/37 (56.8%) children in Mono group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). CD patients in monotherapy showed a significantly increased risk of therapy failure than those treated with combination therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Conversely, no difference was found in UC children (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7). Children undergoing a reactive approach showed more frequent therapy failure compared to proactive in both groups (combo group: 41.7% vs. 4.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01; mono group: 87.5% vs. 20%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In a multivariate regression model, the use of a proactive approach and combination therapy was independently associated with anti\u2010TNF\u2010\u03b1 durability (odds ratio [OR]\u2009=\u200922.1, OR\u2009=\u200912.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combination therapy reduced overall anti\u2010TNF\u2010\u03b1 failure in CD children, but not in UC patients. Additionally, a proactive approach was associated with increased anti\u2010TNF\u2010\u03b1 durability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70280","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T07:35:41Z","timestamp":1763710541000},"page":"454-464","source":"Crossref","is-referenced-by-count":0,"title":["Anti\u2010tumor necrosis factor\u2010\u03b1 monotherapy versus combo therapy with immunosuppressant in pediatric inflammatory bowel disease: A real\u2010life study"],"prefix":"10.1002","volume":"82","author":[{"given":"Flora","family":"Fedele","sequence":"first","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2152-747X","authenticated-orcid":false,"given":"Massimo","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Strisciuglio","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialistic Surgery University of Campania \u201cLuigi Vanvitelli\u201d Napoli Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Scarpato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Staiano","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erasmo","family":"Miele","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics University of Naples \u201cFederico II\u201d Naples 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