关键词: 儿童炎症性肠病, 治疗药物监测, 生物制剂, 英夫利昔单抗, 阿达木单抗, 维得利珠单抗, 乌司奴单抗

Abstract: In the application of biologic agents for pediatric inflammatory bowel disease（IBD），accelerated drug clearance and immunogenicity often lead to subtherapeutic exposure during induction therapy. Even when short-term clinical response or clinical remission is achieved，failure of early trough concentrations to reach target may still increase the risk of subsequent loss of efficacy and loss of response. This article interprets the North American Society for Pediatric Gastroenterology，Hepatology and Nutrition（NASPGHAN）position paper on therapeutic drug monitoring（TDM）in pediatric IBD（2025 edition）to achieve a proactive exposure target-driven framework. We then compared these recommendations with the Practice Guideline for TDM in Pediatric IBD（2025）by Chinese Medical Association，focusing on target drug concentrations for anti-tumor necrosis factor-α agents and other biologics，optimal timing for TDM，stratified management of anti-drug antibodies，and dose-intensification strategies. Key differences in monitoring approaches for high-risk phenotypes-including acute severe ulcerative colitis，perianal Crohn’s disease，and very early-onset IBD- are summarized to provide reference for clinical practice in China.

Key words: pediatric inflammatory bowel disease, therapeutic drug monitoring, biologics, infliximab, adalimumab, vedolizumab, ustekinumab