Medical management of pediatric inflammatory bowel disease

Baldwin, Katherine; Kaplan, Jess L.

doi:10.1053/j.sempedsurg.2017.10.005

Cited by 10 publications

(4 citation statements)

References 78 publications

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“…Steroid-free remission, whether clinically or endoscopically is an important treatment goal for pediatric IBD [ 20 , 37 ], as corticosteroids have potentially serious side effects associated with long term use including linear growth restriction, and osteopenia amongst many others [ 38 ]. In a meta-analysis on adult population, approximately one-quarter of CD or UC achieved CS-free clinical remission at 14 weeks, while 31% of CD and 42% of UC of that at 12 months [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of vedolizumab for pediatrics with inflammatory bowel disease: a systematic review

2022

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Background Vedolizumab use in pediatrics is still off-label and the data are limited. We conducted a systematic review evaluating the efficacy and safety of vedolizumab in children and adolescents with inflammatory bowel disease (IBD). Methods PubMed, EMBASE and Cochrane databases were systematically searched for studies of vedolizumab in children and adolescents with IBD reporting clinical remission, response, corticosteroid-free (CS-free) remission, mucosal healing, or safety up to December 3rd 2021. Results Ten studies, comprising 455 patients were included. For CD, the pooled clinical remission rates were 25% (19/75) at 6 weeks, 28% (25/85) at 14 weeks, 32% (17/53) at 22 weeks, and 46% (43/92) at 1 year. For UC/IBD-U, the pooled clinical remission rates were 36% (25/70) at 6 weeks, 48% (52/101) at 14 weeks, 53% (24/45) at 22 weeks, and 45% (50/112) at 1 year. Mucosal healing was found in 17%-39% of CD and 15%-34% of UC/IBD-U respectively. Six percent of patients reported serious adverse events. Conclusions According to low-quality evidence based on case series, approximately one-third and one-half of patients for CD and UC/IBD-U respectively achieved remission within 22 weeks, and about half of patients achieved remission at 1 year with reasonable safety profile. Long-term benefit profile data and high quality evidence are still needed.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of vedolizumab for pediatrics with inflammatory bowel disease: a systematic review

2022

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“…Steroid-free remission, whether clinically or endoscopically is an important treatment goal for pediatric IBD [20,34], as corticosteroids have potentially serious side effects associated with long term use including linear growth restriction, and osteopenia amongst many others [35]. In a meta-analysis on adult population, approximately one-quarter of CD or UC achieved CS-free clinical remission at 14 weeks, while 31% of CD and 42% of UC of that at 12 months [36].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Vedolizumab for Pediatrics With Inflammatory Bowel Disease: a Systematic Review

Fang

Song

Wang

2021

Preprint

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Background: Vedolizumab use in pediatrics is still off-label and the data are limited. We conducted a systematic review evaluating the efficacy and safety of vedolizumab in children and adolescents with inflammatory bowel disease (IBD). Methods: PubMed, EMBASE and Cochrane databases were systematically searched for studies of vedolizumab in children and adolescents with IBD reporting clinical remission, response, corticosteroid-free (CS-free) remission, mucosal healing, or safety up to November 21 2020. Results: 7 studies, comprising 238 patients were included. For CD, the pooled clinical remission rates were 25% (19/75) at 6 weeks, 28% (19/67) at 14 weeks, 32% (17/53) at 22 weeks, and 25% (1/4) at 1 year. For UC/IBD-U, the pooled clinical remission rates were 36% (25/70) at 6 weeks, 52% (32/61) at 14 weeks, 53% (24/45) at 22 weeks, and 60% (6/10) at 1 year. Mucosal healing was found in 17%-39% of CD and 15%-34% of UC/IBD-U respectively. Six percent of patients reported serious adverse events.Conclusions: According to low-quality evidence based on case series, approximately one-third and one-half of patients for CD and UC/IBD-U respectively achieved remission within 22 weeks. Long-term benefit profile data and high quality evidence are still needed.

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“…Off-label options undergoing further study include vedolizumab, an α 4 β 7 integrin inhibitor, and ustekinumab, a p40 subunit of IL-12 and IL-23 inhibitor. 8 In summary, perianal tags can be an overlooked expression of pediatric NMCCD, leading to delayed diagnosis and morbidity. 1,9 Perianal tags often present months before CD diagnosis, giving the informed dermatologist an opportunity to aid in earlier diagnosis and treatment initiation.…”

Section: Discussionmentioning

confidence: 99%