| Zdroj: |
Merrick, V M, Mortier, K, Williams, L, Muhammed, R, Auth, M K, Elawad, M, Fell, J M, Beattie, R M, Loganathan, S, Torrente, F, Morris, M, Charlton, C, Croft, N M, Rodrigues, A, Furman, M, Vadamalayan, B, Jenkins, H, Zamvar, V, Mitton, S G, Chong, S, Cosgrove, M, Akobeng, A, Wilson, D & Russell, R K 2018, ' Real-Life Anti-Tumour Necrosis Factor Experience in > 500 Paediatric United Kingdom Inflammatory Bowel Disease Patients ', Journal of pediatric gastroenterology and nutrition, vol. 66, no. 2, pp. 274-280 . https://doi.org/10.1097/MPG.0000000000001679 |
| Popis: |
OBJECTIVE: The aim of this study was to measure the effectiveness, safety, and use of anti-tumor necrosis Factor (TNF) therapy in pediatric inflammatory bowel disease in the United Kingdom (UK).METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment +/or the Paediatric Crohn Disease Activity Index.RESULTS: A total of 37 centers participated (23/25 specialist pediatric inflammatory bowel disease sites). A total of 524 patients were included: 429 with Crohn disease (CD), 76 with ulcerative colitis (UC), and 19 with IBD unclassified (IBDU). Eighty-seven percent (488/562) of anti-TNF was infliximab; commonest indication was active luminal CD 77% (330/429) or chronic refractory UC/IBDU 56% (53/95); 79% (445/562) had concomitant co-immunosuppression. In CD (267/429 male), median time from diagnosis to treatment was 1.42 years (interquartile range 0.63-2.97). Disease (at initiation) was moderate or severe in 91% (156/171) by Physician Global Assessment compared to 41% (88/217) by Paediatric Crohn Disease Activity Index (Kappa (κ) 0.28 = only "fair agreement"; P CONCLUSIONS: Anti-TNFs are effective treatments, usually given with thiopurine co-immunosuppression. This study highlights deficiencies in formal documentation of effect and disparity between disease severity scoring tools, which need to be addressed to improve ongoing patient care. |
