Clusters of Disease Activity and Early Risk Factors of Clinical Course of Pediatric Crohn's Disease
© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: This study aimed to define clusters of disease activity and prognostic factors of disease course in a well-characterized cohort of children with Crohn's disease (CD).
METHODS: All patients from the SIGENP IBD (Italian Society of Pediatric Gastroenterology Hepatology and Nutrition Inflammatory Bowel Disease) registry with a 5-year follow-up and 6-monthly evaluation were included. Active disease was defined for each semester as follows: clinical activity (weighted Pediatric Crohn's Disease Activity Index ≥12.5 or Mucosal Inflammation Noninvasive Index ≥8) and active disease on endoscopy (Simple Endoscopic Score for Crohn's Disease >3 or fecal calprotectin >250 µg/g) or imaging. Formula-based clusters were generated based on previously published patterns in adults.
RESULTS: Data from 332 patients were analyzed. A total of 105 (32%) experienced a quiescent disease course; 49 (15%) and 31 (9%) a moderate-to-severe chronically active and chronic intermittent disease, respectively; 104 (31%) and 43 (13%) had active disease in the first 2 years after diagnosis and remission thereafter and vice versa, respectively. Surgery at diagnosis was significantly associated with a quiescent course (odds ratio [OR], 10.05; 95% confidence interval [CI], 3.05-25.22; P=.0005), while growth impairment at the diagnosis and active disease requiring corticosteroids at 6 months were inversely related to the quiescent group (OR, 0.48; 95% CI, 0.27-0.81; P= .007; and OR, 0.35; 95% CI, 0.16-0.71; P= .005, respectively). Perianal involvement at diagnosis and moderate-severe activity at 6 months correlated with disease progression (OR, 3.85; 95% CI, 1.20-12.85; P=.02).
CONCLUSIONS: During the first 5 years of follow-up, one-third of children with CD experience a quiescent course. However, another one-third have a moderate-to-severe disease course. Surgery at the diagnosis is related to a quiescent course, while growth impairment and lack of response to induction therapy correlate with more severe disease activity during follow-up.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
Inflammatory bowel diseases - (2023) vom: 23. Nov. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Distante, Manuela [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Children |
|---|
| Anmerkungen: |
Date Revised 23.11.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1093/ibd/izad275 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM364869828 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM364869828 | ||
| 003 | DE-627 | ||
| 005 | 20231226100417.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ibd/izad275 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1216.xml |
| 035 | |a (DE-627)NLM364869828 | ||
| 035 | |a (NLM)37995723 | ||
| 035 | |a (PII)izad275 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Distante, Manuela |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clusters of Disease Activity and Early Risk Factors of Clinical Course of Pediatric Crohn's Disease |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 23.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: This study aimed to define clusters of disease activity and prognostic factors of disease course in a well-characterized cohort of children with Crohn's disease (CD) | ||
| 520 | |a METHODS: All patients from the SIGENP IBD (Italian Society of Pediatric Gastroenterology Hepatology and Nutrition Inflammatory Bowel Disease) registry with a 5-year follow-up and 6-monthly evaluation were included. Active disease was defined for each semester as follows: clinical activity (weighted Pediatric Crohn's Disease Activity Index ≥12.5 or Mucosal Inflammation Noninvasive Index ≥8) and active disease on endoscopy (Simple Endoscopic Score for Crohn's Disease >3 or fecal calprotectin >250 µg/g) or imaging. Formula-based clusters were generated based on previously published patterns in adults | ||
| 520 | |a RESULTS: Data from 332 patients were analyzed. A total of 105 (32%) experienced a quiescent disease course; 49 (15%) and 31 (9%) a moderate-to-severe chronically active and chronic intermittent disease, respectively; 104 (31%) and 43 (13%) had active disease in the first 2 years after diagnosis and remission thereafter and vice versa, respectively. Surgery at diagnosis was significantly associated with a quiescent course (odds ratio [OR], 10.05; 95% confidence interval [CI], 3.05-25.22; P=.0005), while growth impairment at the diagnosis and active disease requiring corticosteroids at 6 months were inversely related to the quiescent group (OR, 0.48; 95% CI, 0.27-0.81; P= .007; and OR, 0.35; 95% CI, 0.16-0.71; P= .005, respectively). Perianal involvement at diagnosis and moderate-severe activity at 6 months correlated with disease progression (OR, 3.85; 95% CI, 1.20-12.85; P=.02) | ||
| 520 | |a CONCLUSIONS: During the first 5 years of follow-up, one-third of children with CD experience a quiescent course. However, another one-third have a moderate-to-severe disease course. Surgery at the diagnosis is related to a quiescent course, while growth impairment and lack of response to induction therapy correlate with more severe disease activity during follow-up | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a children | |
| 650 | 4 | |a cluster | |
| 650 | 4 | |a prognostic risk factors | |
| 700 | 1 | |a Rotulo, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Ranalli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Pedace, Eugenio |e verfasserin |4 aut | |
| 700 | 1 | |a Lionetti, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Arrigo, Serena |e verfasserin |4 aut | |
| 700 | 1 | |a Alvisi, Patrizia |e verfasserin |4 aut | |
| 700 | 1 | |a Miele, Erasmo |e verfasserin |4 aut | |
| 700 | 1 | |a Martinelli, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Zuin, Giovanna |e verfasserin |4 aut | |
| 700 | 1 | |a Bramuzzo, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Cananzi, Mara |e verfasserin |4 aut | |
| 700 | 1 | |a Aloi, Marina |e verfasserin |4 aut | |
| 700 | 0 | |a SIGENP IBD Working Group |e verfasserin |4 aut | |
| 700 | 1 | |a Baldi, M |e investigator |4 oth | |
| 700 | 1 | |a Banzato, C |e investigator |4 oth | |
| 700 | 1 | |a Barera, G |e investigator |4 oth | |
| 700 | 1 | |a Castellucci, G |e investigator |4 oth | |
| 700 | 1 | |a Corpino, M |e investigator |4 oth | |
| 700 | 1 | |a Cozzali, R |e investigator |4 oth | |
| 700 | 1 | |a De Giacomo, C |e investigator |4 oth | |
| 700 | 1 | |a Diaferia, P |e investigator |4 oth | |
| 700 | 1 | |a Dilillo, D |e investigator |4 oth | |
| 700 | 1 | |a Felici, E |e investigator |4 oth | |
| 700 | 1 | |a Illiceto, M T |e investigator |4 oth | |
| 700 | 1 | |a Knafelz, D |e investigator |4 oth | |
| 700 | 1 | |a Norsa, L |e investigator |4 oth | |
| 700 | 1 | |a Pavanello, P M |e investigator |4 oth | |
| 700 | 1 | |a Ravelli, A |e investigator |4 oth | |
| 700 | 1 | |a Romagnoli, V |e investigator |4 oth | |
| 700 | 1 | |a Romano, C |e investigator |4 oth | |
| 700 | 1 | |a Salvatore, S |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Inflammatory bowel diseases |d 1995 |g (2023) vom: 23. Nov. |w (DE-627)NLM094498598 |x 1536-4844 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:23 |g month:11 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ibd/izad275 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 23 |c 11 | ||