Abstract
The incidence of pediatric inflammatory bowel disease (IBD) is rising, with an especially high proportion of early-onset cases in Asia. Conventional treatments such as glucocorticoids and immunosuppressants have limited efficacy and notable adverse effects, whereas biologic therapies substantially improve remission rates and quality of life. Therapeutic drug monitoring (TDM), by assessing trough concentrations and anti-drug antibodies, enables individualized dose optimization, reduces immunogenicity, and prolongs treatment persistence. However, challenges remain, including insufficient standardization and the lack of pediatric-specific concentration thresholds. This review summarizes recent advances in biologics and TDM in pediatric IBD to inform precision treatment.