Evolution of disease phenotype in adult and pediatric onset Crohn’s disease in a population-based cohort

Abstract

Long-term evolution of disease behavior was not different in pediatric- and adult-onset CD patients in this population-based cohort but was associated to location, perianal disease and smoking status.

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

“…Only a few studies have directly compared paediatric and adult IBD in population‐based cohorts. Data from the French cohort (EPIMAD cohort)which included patients from 1988 to 2006—and the Hungarian cohort (Veszprem cohort) including patients from 1977 to 2008—found that the proportion of patients receiving both immunosuppressive and biologic treatment was significantly higher in patients diagnosed with IBD in childhood than in those diagnosed in adult age, in agreement with our findings. On the contrary, in the Swiss cohort, younger age at diagnosis was associated with higher use of biologics in UC but no difference was found in the use of biologics in CD patients.…”

“…Nevertheless, most of the differences found between childhood‐onset and adulthood‐onset IBD come from the comparison of clinical and epidemiological data from independent patient series (paediatric patients vs adult patients). Up to now, data comparing the evolution of childhood‐onset IBD with that of adulthood‐onset IBD come only from three population cohorts . Results regarding the use of immunosuppressants and biologic agents and the need for surgery according to the age at diagnosis are controversial .…”

Enfermedad inflamatoria intestinal a partir de una experiencia local: Experience in 316 patients

“…Durante la evolución de la enfermedad, se observó un cambio en el fenotipo de 4 pacientes con EC (5%) que inicialmente presentaban fenotipo inflamatorio. Este cambio fue menor al observado por otros estudios que reportan entre 31% y 60% de progresión a una enfermedad más severa [23][24][25] , lo que se podría explicar por ser un estudio retrospectivo, con corto período de seguimiento 3 . Otro factor que podría explicar que el cambio de fenotipo sea menor, es que los pacientes tratados desde su diagnóstico en nuestra institución, tienen tratamiento "step-up acelerado", por lo que podría haber menos cambio de fenotipo al ser tratados de manera más agresiva desde el inicio 26,27 .…”

Presentation and Progression of Childhood-Onset Inflammatory Bowel Disease in Northern Stockholm County

“…[10][11][12][13] Data from these studies suggest that childhood-onset IBD is characterized by more extensive intestinal involvement at diagnosis. During the last decade, several studies have been published, which describe the early disease course of patients with childhood-onset IBD.…”

“…The hypothesis that childhood-onset IBD patients will face a more severe disease course than adults has been questioned recently as some studies have presented less severe outcomes than previously reported. 12,13,19 The introduction of modern immunosuppressive drugs has fueled hopes that early intensive pharmacological treatment might have the potential to modify the IBD disease course. 20 Following this expectation, the treatment paradigm has shifted from focusing on symptomatic control to involve subclinical intestinal inflammation also.…”