Predicting complications in paediatric ulcerative colitis: A longitudinal multicentre cohort study.
Humans
Colitis, Ulcerative
/ drug therapy
Child
Male
Female
Adolescent
Longitudinal Studies
Child, Preschool
Risk Factors
Leukocyte L1 Antigen Complex
/ analysis
Cohort Studies
Recurrence
Feces
/ chemistry
Hospitalization
/ statistics & numerical data
Germany
/ epidemiology
Severity of Illness Index
Austria
/ epidemiology
Biological Products
/ therapeutic use
Registries
Immunologic Factors
/ therapeutic use
Age Factors
Journal
Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234
Informations de publication
Date de publication:
Nov 2024
Nov 2024
Historique:
revised:
10
07
2024
received:
19
06
2024
accepted:
29
08
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
1
11
2024
Statut:
ppublish
Résumé
To prevent complications of paediatric ulcerative colitis (UC), it is critical to understand their predictors. The Paediatric Inflammatory Bowel Disease Ahead (PIBD Ahead) program identified the relevant outcomes and their potential predictors. However, external validation of these results in larger cohorts is required. The aim of this study is to investigate these outcomes and their predictors. We included 743 patients aged under 18 years with UC from the multicentre German-Austrian CEDATA-GPGE registry. We performed Cox regressions, Kaplan-Meier estimator, and receiver operating characteristics curve analyses to analyse predictors of poor outcomes. Older age at diagnosis was associated with relapse, hospitalisation, the use of immunomodulators, use of biologics, and therapy escalation. Higher disease activity, as in acute severe colitis in the first 3 months, was significantly associated with further acute severe colitis and the need for biologics. Upper gastrointestinal tract involvement was a risk factor for the need of intravenous corticosteroids and biologics. A faecal calprotectin of >685 μg/g was associated with a higher risk of subsequent acute severe colitis with a sensitivity of 79.0% and a specificity of 59.1%. A lower haematocrit at diagnosis was predictive of the use of biologics. Colectomy was rare. This study validates predictors of poor outcomes in paediatric patients with UC. Our results might help physicians to anticipate poor outcomes and initiate appropriate treatment strategies at an early stage.
Sections du résumé
BACKGROUND
BACKGROUND
To prevent complications of paediatric ulcerative colitis (UC), it is critical to understand their predictors. The Paediatric Inflammatory Bowel Disease Ahead (PIBD Ahead) program identified the relevant outcomes and their potential predictors. However, external validation of these results in larger cohorts is required.
AIMS
OBJECTIVE
The aim of this study is to investigate these outcomes and their predictors.
METHODS
METHODS
We included 743 patients aged under 18 years with UC from the multicentre German-Austrian CEDATA-GPGE registry. We performed Cox regressions, Kaplan-Meier estimator, and receiver operating characteristics curve analyses to analyse predictors of poor outcomes.
RESULTS
RESULTS
Older age at diagnosis was associated with relapse, hospitalisation, the use of immunomodulators, use of biologics, and therapy escalation. Higher disease activity, as in acute severe colitis in the first 3 months, was significantly associated with further acute severe colitis and the need for biologics. Upper gastrointestinal tract involvement was a risk factor for the need of intravenous corticosteroids and biologics. A faecal calprotectin of >685 μg/g was associated with a higher risk of subsequent acute severe colitis with a sensitivity of 79.0% and a specificity of 59.1%. A lower haematocrit at diagnosis was predictive of the use of biologics. Colectomy was rare.
CONCLUSIONS
CONCLUSIONS
This study validates predictors of poor outcomes in paediatric patients with UC. Our results might help physicians to anticipate poor outcomes and initiate appropriate treatment strategies at an early stage.
Substances chimiques
Leukocyte L1 Antigen Complex
0
Biological Products
0
Immunologic Factors
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1421-1434Investigateurs
Stephan Buderus
(S)
Philip Bufler
(P)
Martin Claßen
(M)
Jan Däbritz
(J)
Söhnke Dammann
(S)
Jan de Laffolie
(J)
Michael Friedt
(M)
Almuthe Christina Hauer
(AC)
Klaus-Michael Keller
(KM)
Andreas Krahl
(A)
Martin Laaß
(M)
Thomas Lang
(T)
Carsten Posovszky
(C)
Burkhard Rodeck
(B)
Stefan Trenkel
(S)
Informations de copyright
© 2024 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
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