{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:24:43Z","timestamp":1791915883898,"version":"4.3.4"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T00:00:00Z","timestamp":1656720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010983","name":"Health Research Fund of Central Denmark Region","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Colitis-Crohn Organization Denmark"},{"name":"A.P. Moeller Foundation"},{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Alfred Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>For infants exposed in utero to anti-tumour necrosis factor-\u03b1 [TNF] medications, it is advised that live-attenuated vaccinations be postponed until the drug is cleared, but little is known about time to clearance. To minimize delays before live-attenuated vaccination can be given, we aimed to develop a pharmacokinetic model to predict time-to-clearance in infants exposed during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively followed in utero infliximab\/adalimumab-exposed infants of mothers with inflammatory bowel disease across four countries between 2011 and 2018. Infants with a detectable anti-TNF umbilical-cord level and at least one other blood sample during the first year of life were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 107 infants were enrolled, including 166 blood samples from 71 infliximab-exposed infants and 77 samples from 36 adalimumab-exposed infants. Anti-TNF was detectable in 23% [n\u2005=\u200525] of infants at 6 months. At 12 months, adalimumab was not detected but 4% [n\u2005=\u20053] had detectable infliximab. A Bayesian forecasting method was developed using a one-compartment pharmacokinetic model. Model validation showed that the predicted clearing time was in accordance with the measured observations. A clinician-friendly online calculator was developed for calculating full anti-TNF clearing time: https:\/\/xiaozhu.shinyapps.io\/antiTNFcalculator2\/.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Almost one-quarter of infants born to mothers receiving anti-TNF during pregnancy have detectable anti-TNF at 6 months. To limit the time to live-attenuated vaccination in infants of mothers receiving anti-TNF during pregnancy, the results of a cord drug level at birth and a second sample \u2265\u20051 month thereafter can be used to estimate the time for full anti-TNF clearance in these children.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjac093","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T15:16:53Z","timestamp":1656775013000},"page":"1835-1844","source":"Crossref","is-referenced-by-count":17,"title":["Timing of Live Attenuated Vaccination in Infants Exposed to Infliximab or Adalimumab<i>in Utero<\/i>: A Prospective Cohort Study in 107 Children"],"prefix":"10.1093","volume":"16","author":[{"given":"Zheng","family":"Liu","sequence":"first","affiliation":[{"name":"Clinical Pharmacology, School of Medicine and Public Health, University of Newcastle, Hunter Medical Research Institute , Kookaburra Circuit , Australia"},{"name":"Clinical Pharmacology, 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