{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T23:49:14Z","timestamp":1776296954712,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>This study aims to evaluate the real-life durability of biologic therapies and to identify factors associated with biologic persistence in pediatric inflammatory bowel disease (IBD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from the IBD-registry of the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (SIGENP) of patients initiating biologics between 2009 and 2022 and \u22651-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1184 patients (747 with Crohn\u2019s disease [CD], 437 with ulcerative colitis or IBD unclassified [UC\/IBD-U]) were included, accounting for 1709 treatment courses. The median follow-up was 43 months (interquartile range 28-64). Overall, 33% received a second-line biologic, 9% third-line, and 2% fourth-line. First-line biologic durability was significantly lower in UC\/IBD-U vs CD, with inferior persistence at 1, 2, and 3 years (61%, 51%, and 44% vs 88%, 75%, and 67%; hazard ratios [HR]: 1.5, 95% confidence interval [CI] 1.2-1.9, P\u2009=\u2009.002). In CD, infliximab had inferior durability then adalimumab (72%, 59%, and 50% vs 91%, 82%, and 77%; HR 2.0, 95% CI, 1.5-2.7, P\u2009&amp;lt;\u2009.0001). In both CD and UC\/IBD-U, age &amp;lt;6 years was a risk factor for treatment discontinuation (HR 1.8, 95% CI, 1.2-2.7, P\u2009&amp;lt;\u2009.01) while therapeutic drug monitoring (TDM) emerged as protective (HR 0.5, 95% CI, 0.4-0.7, P\u2009&amp;lt;\u2009.0001). Combination with an immunomodulator had no significant impact on durability (HR 0.9, 95% CI, 0.8-1.2, P\u2009=\u2009.54).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Biologic persistence varied by disease type and biologic agent. TDM was associated with longer treatment durability, while combination therapy had a limited effect. Further prospective studies are needed to refine biologics optimization strategies in pediatric IBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf164","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T02:51:53Z","timestamp":1758336713000},"source":"Crossref","is-referenced-by-count":2,"title":["Real-life durability and risk factors for biologic discontinuation in pediatric inflammatory bowel disease: results from the SIGENP IBD registry"],"prefix":"10.1093","volume":"19","author":[{"given":"Sara","family":"Lega","sequence":"first","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS Burlo Garofolo , Trieste,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Dipasquale","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood \u201cG. 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