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Management of Paediatric Ulcerative Colitis, Part 1

Authors :
Turner, Dan
Ruemmele, Frank M.
Orlanski-Meyer, Esther
Griffiths, Anne M.
Carpi, Javier Martin
Bronsky, Jiri
Veres, Gabor
Aloi, Marina
Strisciuglio, Caterina
Braegger, Christian P.
Assa, Amit
Romano, Claudio
Hussey, Séamus
Stanton, Michael
Pakarinen, Mikko
Ridder, Lissy
Katsanos, Konstantinos
Croft, Nick
Navas-López, Victor
Wilson, David C.
Lawrence, Sally
Russell, Richard K.
Source :
Journal of Pediatric Gastroenterology & Nutrition; August 2018, Vol. 67 Issue: 2 p257-291, 35p
Publication Year :
2018

Abstract

The contemporary management of ambulatory ulcerative colitis (UC) continues to be challenging with ~20% of children needing a colectomy within childhood years. We thus aimed to standardize daily treatment of pediatric UC and inflammatory bowel diseases (IBD)-unclassified through detailed recommendations and practice points. These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). An extensive literature search with subsequent evidence appraisal using robust methodology was performed before 2 face-to-face meetings. All 40 included recommendations and 86 practice points were endorsed by 43 experts in Paediatric IBD with at least an 88% consensus rate. These guidelines discuss how to optimize the use of mesalamine (including topical), systemic and locally active steroids, thiopurines and, for more severe disease, biologics. The use of other emerging therapies and the role of surgery are also covered. Algorithms are provided to aid therapeutic decision-making based on clinical assessment and the Paediatric UC Activity Index (PUCAI). Advice on contemporary therapeutic targets incorporating the use of calprotectin and the role of therapeutic drug monitoring are presented, as well as other management considerations around pouchitis, extraintestinal manifestations, nutrition, growth, psychology, and transition. A brief section on disease classification using the PIBD-classes criteria and IBD-unclassified is also part of these guidelines. These guidelines provide a guide to clinicians managing children with UC and IBD-unclassified management to provide modern management strategies while maintaining vigilance around appropriate outcomes and safety issues.

Details

Language :
English
ISSN :
02772116 and 15364801
Volume :
67
Issue :
2
Database :
Supplemental Index
Journal :
Journal of Pediatric Gastroenterology & Nutrition
Publication Type :
Periodical
Accession number :
ejs65087971
Full Text :
https://doi.org/10.1097/MPG.0000000000002035