Anti-TNF therapies other than infliximab for the treatment of pediatric inflammatory bowel disease

The cornerstone of inflammatory bowel disease (IBD) therapy for the last 20 years has revolved around biologic agents targeting tumor necrosis factor alpha (TNFα). Since the approval of infliximab as the first anti-TNFα agent to treat Crohn disease (CD) and ulcerative colitis (UC), other agents also targeting TNFα have come to market, including adalimumab, certolizumab, and golimumab. These agents differ in their route of administration as well as antibody structure. In this chapter we will review the clinical efficacy, safety, and future directions for this class of drugs. To date, there are very few randomized controlled trials evaluating the use of anti-TNFα drugs in pediatric IBD; therefore, the majority of the support for their use in pediatric CD and UC comes from observational studies or extrapolation from the adult literature.