1. Long-term Outcomes of Paediatric Patients Admitted With Acute Severe Colitis-A Multicentre Study From the Paediatric IBD Porto Group of ESPGHAN
- Author
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Elena Daniela Serban, Sreedhar Subramanian, Claudio Romano, Mikkel Malham, Christos Tzivinikos, Ibrahim Shamasneh, Javier Martín-de-Carpi, Oren Ledder, Tim G. J. de Meij, M. Sladek, Iva Hojsak, Kwangyang Lee, Nicholas M. Croft, Nadeem A. Afzal, Paolo Lionetti, Seamus Hussey, Avantika Singh, Caterina Strisciuglio, Hien Q. Huynh, Amit Assa, Harland S. Winter, Richard K. Russell, Valeria Dipasquale, Alex Krauthammer, Neil Shah, Dror S. Shouval, Darja Urlep, Batia Weiss, Huey Miin Lee, Anat Yerushalmy-Feler, Erasmo Miele, Eytan Wine, Marina Aloi, Víctor Manuel Navas-López, Krauthammer, A., Tzivinikos, C., Assa, A., Miele, E., Strisciuglio, C., Urlep, D., Serban, E. D., Singh, A., Winter, H. S., Russell, R. K., Hojsak, I., Malham, M., Navas-López, V. M., Croft, N. M., Lee, H. M., Ledder, O., Shamasneh, I., Hussey, S., Huynh, H., Wine, E., Shah, N., Sladek, M., de Meij, T. G., Romano, C., Dipasquale, V., Lionetti, P., Afzal, N. A., Aloi, M., Lee, K., Martín-de-Carpi, J., Yerushalmy-Feler, A., Subramanian, S., Weiss, B., Shouval, D. S., Navas-Lopez, V. M., Huynh, H. Q., and Martin-de-Carpi, J.
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Long Term Adverse Effects ,acute severe colitis, anti-TNFa, biologics, colectomy, UC ,Severity of Illness Index ,acute severe coliti ,03 medical and health sciences ,0302 clinical medicine ,UC ,Internal medicine ,medicine ,Humans ,biologics ,Colitis ,Child ,Glucocorticoids ,acute severe colitis ,Retrospective Studies ,Colectomy ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Retrospective cohort study ,General Medicine ,medicine.disease ,colectomy ,Ulcerative colitis ,Infliximab ,Europe ,Outcome and Process Assessment, Health Care ,030104 developmental biology ,anti-TNFa ,Therapeutic drug monitoring ,Erythrocyte sedimentation rate ,North America ,Cohort ,Colitis, Ulcerative ,Female ,Tumor Necrosis Factor Inhibitors ,030211 gastroenterology & hepatology ,business ,biologic ,medicine.drug - Abstract
Background and AimAcute severe colitis [ASC] is associated with significant morbidity in paediatric patients with ulcerative colitis [UC]. Most outcome studies in ASC since tumour necrosis factor alpha [TNFα] antagonists became available have focused on the first year after admission. The aim of this study was to characterise the longer-term outcomes of paediatric patients admitted with ASC.MethodsThis retrospective study was conducted in 25 centres across Europe and North America. Data on patients with UC aged ResultsOf the 141 patients admitted with ASC, 137 [97.1%] were treated with intravenous corticosteroids. Thirty-one [22.6%] patients were escalated to second-line therapy, mainly to infliximab. Sixteen patients [11.3%] underwent colectomy before discharge. Long-term follow-up showed colectomy-free rates were 71.3%, 66.4% and 63.6% at 1, 3 and 5 years after initial ASC admission, respectively, and were similar across different age groups. Sub-analysis of colectomy rates in patients with new-onset disease [42.5% of the cohort] yielded similar results. In a multivariate analysis, use of oral steroids in the 3 months before admission, erythrocyte sedimentation rate >70 mm/h, and albumin ConclusionsHigh colectomy rates were demonstrated in paediatric UC patients admitted with ASC. Additional studies are required to determine whether intensification of anti-TNFα treatment, close therapeutic drug monitoring, and use of new drugs alter this outcome.
- Published
- 2019