{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:09:05Z","timestamp":1789103345262,"version":"build-2803163510"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Children\u2019s Medical and Research Foundation, Ireland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Proactive drug monitoring in our national cohort of children with inflammatory bowel disease suggested that 5 mg\/kg dosing of infliximab (IFX) was associated with inadequate trough levels (TLs), thus we commenced empiric 10 mg\/kg dosing in 2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective study of patients commenced on 5 or 10 mg\/kg IFX between 2018 and 2020. The primary outcome was pre-fourth TL \u22655 \u00b5g\/mL. Data source verification and analysis were undertaken retrospectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the study period, 122 patients were commenced on IFX and eligible for inclusion. Of these, 72% were male, 76% had Crohn\u2019s disease (CD), 23% had ulcerative colitis; mean (standard deviation [SD]) age at diagnosis was 11.8 (2.7) years; 60 commenced 5 mg\/kg. Baseline parameters were comparable between groups. Fewer patients in the 5 mg\/kg than 10 mg\/kg group had pre-fourth TLs \u22655 \u00b5g\/mL (6\/48 [12.5%] vs 28\/50 [56%], P\u2005&amp;lt;\u2005.001; mean [SD] TL 3.5 [6.3] vs 10.0 [9.9], P\u2005&amp;lt;\u2005.001). The 5 mg\/kg group was less likely to have target pre-third TLs (6% vs 80%, P\u2005&amp;lt;\u2005.001); more likely to have treatment escalation (78% vs 45%, P\u2005&amp;lt;\u2005.001), and less likely to de-escalate (10% vs 29% P\u2005=\u2005.008). Proactive therapeutic dose monitoring (TDM) was practiced throughout the study period and mean (SD) IFX exposure per kg\/week was similar in both groups by 1 year (1.4 [0.43] vs 1.56 [0.56] mg\/kg\/week, P\u2005=\u2005.137), as were infliximab durability and clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our real-world data show that 5 mg\/kg infliximab induction does not achieve target TLs in most children with CD. Higher-dose regimens should be considered, especially if proactive therapeutic drug monitoring is not available.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izaf031","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T14:00:05Z","timestamp":1741096805000},"page":"2331-2337","source":"Crossref","is-referenced-by-count":4,"title":["Higher-Dose Infliximab Induction Achieves Better Maintenance Trough Levels in a National Pediatric IBD Cohort\u2014A Retrospective Study"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4101-4383","authenticated-orcid":false,"given":"Emily","family":"Stenke","sequence":"first","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahlal","family":"Alhassan","sequence":"additional","affiliation":[{"name":"National Centre for 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Health Ireland at Crumlin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciara","family":"Lang","sequence":"additional","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6809-7839","authenticated-orcid":false,"given":"Shoana","family":"Quinn","sequence":"additional","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6001-4151","authenticated-orcid":false,"given":"Annemarie","family":"Broderick","sequence":"additional","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]},{"name":"School 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,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-6525","authenticated-orcid":false,"given":"Lorraine","family":"Stallard","sequence":"additional","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9362-0465","authenticated-orcid":false,"given":"S\u00e9amus","family":"Hussey","sequence":"additional","affiliation":[{"name":"National Centre for Pediatric Gastroenterology, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]},{"name":"The DOCHAS Study, Children's Health Ireland at Crumlin , Dublin ,","place":["Ireland"]},{"name":"School of Medicine, University College Dublin , Dublin ,","place":["Ireland"]},{"name":"Department of Pediatrics, Royal College of Surgeons of Ireland , Dublin 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