Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Autor: Chaparro, M, Garre, A, Ricart, E, Iglesias-Flores, E, Taxonera, C, Manosa, M, Mendoza, IV, Minguez, M, Arguelles, F, Parga, LD, Arroyo, M, Lopez-Sanroman, A, Tirado, MR, Guardiola, J, Arranz, MDM, Beltran, B, Barrio, J, Riestra, S, Garcia-Planella, E, Calvet, X, Alcain, G, Sicilia, B, Garcia, S, Esteve, M, Marquez, L, Salazar, LIF, Casbas, AG, Piqueras, M, Bermejo, F, Calle, JLP, Hinojosa, J, Perez, AR, Aldeguer, X, Sepulcre, MFG, Bujanda, L, Montiel, PM, Poyatos, RL, Gutierrez, CR, Merino, O, Cabriada, JL, Roncero, O, Cara, PR, Navarro-Llavat, M, Ber, Y, Madrigal, RE, Van Domselaar, M, Barreiro-de Acosta, M, Llao, J, Ramos, L, Riera, J, Villarin, AJL, Gonzalez, ER, Malaves, JMH, Villafranca, CM, Almela, P, Charro, M, de la Piscina, PR, Sese, E, Lacruz, AA, Khorrami, S, Alvarado, VJM, Gil, JL, Martinez, AMT, Villaroya, RP, Acevedo, J, Herola, AG, Villalba, LH, Munoz, E, Duran, MTN, Menacho, M, Lopez, VMN, Retamero, MD, Bernardo, D, Muriel, A, Domenech, E, Gisbert, JP, ENEIDA Study Grp
Rok vydání: 2019
Zdroj: ALIMENTARY PHARMACOLOGY & THERAPEUTICS
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
r-FISABIO: Repositorio Institucional de Producción Científica
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
ISSN: 0269-2813
Popis: Background Cohort studies comparing the characteristics of childhood-onset and adulthood-onset inflammatory bowel disease (IBD) in the biologics era are scarce. Aim To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood- and adulthood-onset IBD. Methods Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood-onset cohort comprised patients diagnosed at 16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan-Meier curves, compared by the log-rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. Results The adulthood-onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood-onset cohort 846 (4%). Median follow-up was 54 months in the childhood-onset cohort and 38 months in the adulthood-onset cohort (P < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood-onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood-onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1-1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1-1.3). However, childhood-onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8-1.2). Conclusions Childhood-onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood-onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery.
Databáze: OpenAIRE
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