{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:19:03Z","timestamp":1780604343898,"version":"3.54.1"},"reference-count":53,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hospital Pharmacy of the Fundaci\u00f3n Espa\u00f1ola de Farmacia Hospitalaria (FEFH)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: This study evaluated the long-term effectiveness and safety of a multidisciplinary early proactive therapeutic drug monitoring (TDM) program combined with Bayesian forecasting for infliximab (IFX) dose adjustment in a real-world dataset of paediatric patients with inflammatory bowel disease (IBD). Methods: A descriptive, ambispective, single-centre study of paediatric patients with IBD who underwent IFX serum concentration measurements between September 2015 and September 2023. The patients received reactive TDM before September 2019 (n = 17) and proactive TDM thereafter (n = 21). We analysed for clinical, biological, and endoscopic remission; treatment failure; hospitalisations; emergency visits; and adverse drug reactions. The IFX doses were adjusted to maintain trough concentrations \u2265 5 \u00b5g\/mL, with specific targets for proactive TDM. Results: Of the 38 patients, 21 had Crohn\u2019s disease (CD), 16 ulcerative colitis (UC), and 1 undetermined IBD. The mean (standard deviation) IFX trough concentrations were 6.83 (5.66) \u00b5g\/mL (reactive) and 12.38 (9.24) \u00b5g\/mL (proactive) (p = 0.08). No statistically significant differences between groups were found in remission rates or treatment failure. The proactive group had fewer hospitalisations (14.29% vs. 23.53%; p = 0.47) and shorter median hospitalisation days (6 vs. 19; p = 0.50), although the difference was not statistically significant. The number of patients with adverse reactions (infusion related reactions and infections) was higher in the proactive group (38.10% vs. 23.53%; p = 0.34) but the difference was not significantly different. Conclusions: Proactive TDM showed no significant differences in treatment outcomes compared to reactive TDM. However, the results in both the reactive and proactive TDM groups were not worse than those reported in other studies. Further studies with larger samples are needed to optimize the treatment strategies for pediatric IBD patients.<\/jats:p>","DOI":"10.3390\/pharmaceutics16121577","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T11:17:20Z","timestamp":1733829440000},"page":"1577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Effectiveness and Safety of Proactive Therapeutic Drug Monitoring of Infliximab in Paediatric Inflammatory Bowel Disease: A Real-World Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6272-6438","authenticated-orcid":false,"given":"Susana","family":"Clemente Bautista","sequence":"first","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d3scar","family":"Segarra Cant\u00f3n","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology and Clinical Nutrition Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"},{"name":"Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine and Public Health of the Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Padull\u00e9s-Zamora","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari de Bellvitge-IDIBELL, Feixa Llarga s\/n, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-4770","authenticated-orcid":false,"given":"Sonia","family":"Garc\u00eda Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"\u00c1lvarez Beltr\u00e1n","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology and Clinical Nutrition Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6492-0568","authenticated-orcid":false,"given":"Mar\u00eda","family":"Larrosa Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Josep","family":"Caba\u00f1as Poy","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Sanz-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Immunology Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-1667","authenticated-orcid":false,"given":"Ana","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Department of Applied Statistics, Universitat Aut\u00f2noma de Barcelona, Bellaterra, 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-5171","authenticated-orcid":false,"given":"Maria Queralt","family":"Gorgas Torner","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7847-1580","authenticated-orcid":false,"given":"Marta","family":"Miarons","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Hospital Universitari Vall d\u2019Hebron, Vall d\u2019Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain"},{"name":"Pharmacy Department, Consorci Hospitalari de Vic, 08500 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"ref_1","unstructured":"(2024, April 03). 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