Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2023; 29(38): 5428-5434
Published online Oct 14, 2023. doi: 10.3748/wjg.v29.i38.5428
Dose escalation of adalimumab as a strategy to overcome anti-drug antibodies: A case report of infantile-onset inflammatory bowel disease
Silvana Ancona, Sara Signa, Chiara Longo, Giuliana Cangemi, Roberta Carfora, Enrico Drago, Alessandro La Rosa, Marco Crocco, Andrea Chiaro, Paolo Gandullia, Serena Arrigo
Silvana Ancona, Chiara Longo, Roberta Carfora, Enrico Drago, Alessandro La Rosa, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università degli Studi di Genova, Genova 16126, Italy
Sara Signa, Chiara Longo, Alessandro La Rosa, Marco Crocco, Andrea Chiaro, Paolo Gandullia, Serena Arrigo, Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genova 16147, Italy
Giuliana Cangemi, Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, Genova 16147, Italy
Author contributions: Ancona S, Signa S, Longo C, Carfora R, and Drago E contributed to manuscript writing and editing, and data collection; Cangemi G contributed to therapeutic drug monitoring and data collection; Arrigo S, Gandullia P, Crocco M, La Rosa A, and Chiaro A contributed to conceptualization and supervision; and all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Serena Arrigo, MD, Staff Physician, Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, 5 Via Gerolamo Gaslini, Genova 16147, Italy. serenaarrigo@gaslini.org
Received: June 7, 2023
Peer-review started: June 7, 2023
First decision: July 7, 2023
Revised: July 21, 2023
Accepted: July 27, 2023
Article in press: July 27, 2023
Published online: October 14, 2023
Processing time: 126 Days and 15.6 Hours
Core Tip

Core Tip: Infantile-onset inflammatory bowel disease (IBD) frequently has a more severe course and a greater resistance to standard therapy than IBD in older children. Anti-tumor necrosis factor agents often lead to the production of anti-drug antibodies, resulting in loss of clinical response and disease progression. For this reason, the early detection of anti-drug antibodies is important, which may be possible with therapeutic drug monitoring. To date, commonly used strategies to overcome anti-drug antibodies are switching drugs or adding an immunomodulator, but a better option may be dose escalation.