Disease course of ulcerative proctitis in children: A population-based study on behalf of the SIGENP IBD Group.

Children Proctitis Ulcerative Colitis

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
20 Jul 2023
Historique:
received: 29 03 2023
revised: 19 06 2023
accepted: 10 07 2023
medline: 23 7 2023
pubmed: 23 7 2023
entrez: 22 7 2023
Statut: aheadofprint

Résumé

The natural history of ulcerative proctitis (UP) has been poorly investigated in children. We aimed to compare the disease course of children with UP at diagnosis to the other locations and to identify extension predictors. This was a multicenter, observational study carried out from data prospectively entered in the SIGENP-IBD-Registry. Children with ulcerative colitis (UC) diagnosis and at least 1-year follow-up were included. On the basis of Paris classification UP patients were identified and compared with the other locations. 872 children were enrolled (median age at diagnosis: 11.2 years; M/F: 426/446), of whom 78 (9%) with UP. Kaplan-Meier analysis demonstrated increased cumulative probabilities of disease extension in the E1 group [1 year: 20.3%; 5 years: 52.7%; 10 years: 72.4%] compared to E3 group [1 year: 8.5%; 5 years: 24.9% and 10 years: 60.1%, p=0.001]. No differences were observed comparing E1 and E2 groups [p=0.4]. Cumulative probabilities of surgery at 1, 5 and 10 years were 1.3, 2.8 and 2.8% in the E1 group and 2.5, 8 and 12.8% in the E2-E3-E4 group, respectively (p=0.1). Cox regression analysis demonstrated that PUCAI>35 at diagnosis was associated with endoscopic extension (HR=4.9; CI 95% 1.5-15.2, p=0.006). UP is associated with similar short and long-term outcomes compared to other locations.

Sections du résumé

BACKGROUND BACKGROUND
The natural history of ulcerative proctitis (UP) has been poorly investigated in children.
AIMS OBJECTIVE
We aimed to compare the disease course of children with UP at diagnosis to the other locations and to identify extension predictors.
METHODS METHODS
This was a multicenter, observational study carried out from data prospectively entered in the SIGENP-IBD-Registry. Children with ulcerative colitis (UC) diagnosis and at least 1-year follow-up were included. On the basis of Paris classification UP patients were identified and compared with the other locations.
RESULTS RESULTS
872 children were enrolled (median age at diagnosis: 11.2 years; M/F: 426/446), of whom 78 (9%) with UP. Kaplan-Meier analysis demonstrated increased cumulative probabilities of disease extension in the E1 group [1 year: 20.3%; 5 years: 52.7%; 10 years: 72.4%] compared to E3 group [1 year: 8.5%; 5 years: 24.9% and 10 years: 60.1%, p=0.001]. No differences were observed comparing E1 and E2 groups [p=0.4]. Cumulative probabilities of surgery at 1, 5 and 10 years were 1.3, 2.8 and 2.8% in the E1 group and 2.5, 8 and 12.8% in the E2-E3-E4 group, respectively (p=0.1). Cox regression analysis demonstrated that PUCAI>35 at diagnosis was associated with endoscopic extension (HR=4.9; CI 95% 1.5-15.2, p=0.006).
CONCLUSIONS CONCLUSIONS
UP is associated with similar short and long-term outcomes compared to other locations.

Identifiants

pubmed: 37481430
pii: S1590-8658(23)00760-0
doi: 10.1016/j.dld.2023.07.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The authors have no conflict of interests to declare with regards to this manuscript.

Auteurs

Massimo Martinelli (M)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, Naples 80131, Italy.

Flora Fedele (F)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, Naples 80131, Italy.

Claudio Romano (C)

Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy.

Marina Aloi (M)

Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy.

Paolo Lionetti (P)

University of Florence-Meyer Hospital, Florence, Italy.

Patrizia Alvisi (P)

Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.

Serena Arrigo (S)

Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy.

Luca Bosa (L)

Department of Women's and Children's Health, Unit of Pediatric Gastroenterology Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Padua, Italy.

Matteo Bramuzzo (M)

Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.

Giulia D'Arcangelo (G)

Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy.

Valeria Dipasquale (V)

Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy.

Enrico Felici (E)

Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy.

Maurizio Fuoti (M)

Pediatric Gastroenterology and GI Endoscopy, University Department of Pediatrics, Children's Hospital, Spedali Civili, Brescia, Italy.

Simona Gatti (S)

Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.

Francesco Graziano (F)

Villa Sofia Cervello Hospital, Pediatric Unit, Palermo, Italy.

Maria Teresa Illiceto (MT)

Santo Spirito Hospital, Pediatric Gastroenterology and Endoscopic Unit- Department of Pediatrics, Pescara, Italy.

Flavio Labriola (F)

Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.

Lorenzo Norsa (L)

Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Maria Pastore (M)

Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy.

Luca Scarallo (L)

University of Florence-Meyer Hospital, Florence, Italy.

Caterina Strisciuglio (C)

Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

Giovanna Zuin (G)

Department of Pediatrics, University of Milano-Bicocca, Foundation MBBM/San Gerardo Hospital, Monza, Italy.

Erasmo Miele (E)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, Naples 80131, Italy. Electronic address: erasmo.miele@unina.it.

Annamaria Staiano (A)

Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini, 5, Naples 80131, Italy.

Classifications MeSH