Biologics in the management of pediatric inflammatory bowel disease: When and what to choose

Core Tip

Core Tip: Biologics have revolutionized the treatment of pediatric inflammatory bowel disease. The increasing number of biologics (anti-tumor necrosis factor alpha, anti-interleukin 12/23 agents, anti-alpha4beta7 integrin agents) and the arrival of small molecules (Janus kinase inhibitors, sphingosine 1-phosphate-inhibitors), have added to our therapeutic armamentarium. The ultimate objective of therapy is to achieve clinical remission and mucosal healing by providing “personalized therapy” keeping in mind the disease particulars, and selecting the therapy based on the efficacy, cost and safety of the biologics. In this review, we have summarized the recent available literature for guiding the pediatric gastroenterologist about the practical use of biologics and small molecules for children with inflammatory bowel disease.