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Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease
- Source :
- Journal of Crohn's and Colitis, 8(10), 1179-1207. Oxford University Press, Journal of Crohn's & Colitis, 8(10), 1179-1207. Oxford University Press, Ruemmele, F M, Veres, G, Kolho, K L, Griffiths, A, Levine, A, Escher, J C, Amil Dias, J, Barabino, A, Braegger, C P, Bronsky, J, Buderus, S, Martín-de-Carpi, J, De Ridder, L, Fagerberg, U L, Hugot, J P, Kierkus, J, Kolacek, S, Koletzko, S, Lionetti, P, Miele, E, Navas López, V M, Paerregaard, A, Russell, R K, Serban, D E, Shaoul, R, Van Rheenen, P, Veereman, G, Weiss, B, Wilson, D, Dignass, A, Eliakim, A, Winter, H, Turner, D, ECCO/ESPGHAN & Knudsen, T 2014, ' Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease ', Journal of Crohn's and Colitis, vol. 8, no. 10, pp. 1179-1207 . https://doi.org/10.1016/j.crohns.2014.04.005
- Publication Year :
- 2014
- Publisher :
- Oxford University Press, 2014.
-
Abstract
- Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach. These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.
- Subjects :
- Medical therapy
POPULATION-BASED COHORT
Azathioprine
Disease
Guideline
Inflammatory bowel disease
law.invention
Randomized controlled trial
Maintenance therapy
Crohn Disease
law
Adrenal Cortex Hormones
Medicine
Child
DEVELOP REGISTRY DATA
Pediatric
Crohn's disease
Mercaptopurine
Anti-Inflammatory Agents, Non-Steroidal
Remission Induction
Gastroenterology
Antibodies, Monoclonal
General Medicine
3. Good health
Anti-Bacterial Agents
Thalidomide
Algorithms
Immunosuppressive Agents
medicine.drug
medicine.medical_specialty
Adolescent
NEWLY-DIAGNOSED CHILDREN
610 Medicine & health
NONMELANOMA SKIN CANCERS
Guidelines
Antibodies, Monoclonal, Humanized
Maintenance Chemotherapy
Enteral Nutrition
Adalimumab
Humans
2715 Gastroenterology
EXCLUSIVE ENTERAL NUTRITION
Intensive care medicine
PLACEBO-CONTROLLED TRIALS
TERM-FOLLOW-UP
SINGLE-CENTER COHORT
business.industry
Tumor Necrosis Factor-alpha
medicine.disease
Infliximab
Surgery
Aminosalicylic Acids
Methotrexate
10036 Medical Clinic
RANDOMIZED-CONTROLLED-TRIAL
business
INFLAMMATORY-BOWEL-DISEASE
Subjects
Details
- ISSN :
- 18739946
- Volume :
- 8
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Crohn's and Colitis
- Accession number :
- edsair.doi.dedup.....f2d9975d3779d3006786631999c83fb8