Mortality and Cancer in Pediatric-Onset Inflammatory Bowel Disease: A Population-Based Study

Peneau, A.; Savoye, Guillaume; Turck, Dominique; Dauchet, Luc; Fuméry, Mathurin; Salleron, Julia; Lerebours, Éric; Ligier, Karine; Vasseur, Francis; Dupas, Jean‐Louis; Mouterde, O.; Spyckerelle, C.; Djeddi, Djamal-Dine; Peyrin–Biroulet, Laurent; Colombel, Jean–Frédéric; Gower‐Rousseau, Corinne

doi:10.1038/ajg.2013.242

Cited by 58 publications

(44 citation statements)

References 43 publications

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“…[34] In our patients the mortality rate was 1.5% (95% CI: 0-3.7%). Peneau et al [35] analyzed the mortality rate in children with IBD in France and found that the mortality rate was 0.84%, which was not different from the rate of the general population.…”

Section: Original Articlementioning

confidence: 97%

Inflammatory bowel disease in Turkish children

Çakır¹,

Ünal²,

Dinler

et al. 2015

World J Pediatr

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Section: Original Articlementioning

confidence: 97%

Inflammatory bowel disease in Turkish children

Çakır¹,

Ünal²,

Dinler

et al. 2015

World J Pediatr

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“…145 In a pediatric population based cohort of 698 patients with IBD (160 with ulcerative colitis) diagnosed at a median age of 14 and with a median follow-up of 15 years, two patients developed colon cancer. 146 Pediatric gastroenterologists should discuss this complication with families, especially in cases of early onset IBD and during discussion for transition of care to an adult provider. The absolute risk for developing colorectal cancer over a 35 year period was higher if IBD was diagnosed before 15 years of age.…”

Section: Lymphomamentioning

confidence: 99%

Diagnosis and management of inflammatory bowel disease in children

Oliveira

Monteiro

2017

BMJ

116

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Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are lifelong conditions that often begin in childhood. The implications of IBD are of particular importance in children because of the potential negative effects on growth, development, psychosocial function, and overall wellbeing. The key management strategy is to achieve sustained control of intestinal inflammation and monitor for potential complications of the disease and side effects of therapies. Overall, the evidence on the management of IBD in children is less extensive than in adults, but good quality multicenter studies and various guidelines and society consensus statements are available. This review summarizes the evidence on the pathophysiology, diagnosis, and approaches to management of children and adolescents with IBD.

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“…These data suggest that the risk is low, because only these three cases were identified during a 6-year period in 20 countries, although thiopurine use was common during this period. The second identified, in a cohort of 698 pediatric patients with IBD, nine malignancies during a median follow-up period of 15 years (range 10-17) [36]. The crude rate of cancer was 1.3 %, with a significant threefold increased risk of cancer (SIR 3.0; 95 % CI 1.3-5.9).…”

Section: Malignanciesmentioning

confidence: 98%

Long-Term Safety of Immunomodulators in Pediatric Inflammatory Diseases

2014

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The medical management of chronic inflammatory disorders in children, including mainly inflammatory bowel diseases and rheumatic diseases, has evolved dramatically over recent years with the advent of disease-modifying drugs such as immunomodulators and biological agents capable of interrupting the inflammatory cascade underlying these disorders. These agents are generally administered in patients who are refractory to conventional therapies. However, there is growing support that their use in the initial phases of these disorders, especially in pediatric patients, could interrupt and cease the inflammatory process. Thus, the aims of therapy have transitioned from symptomatic control to the achievement of deeper remission, including the healing of the inflammatory lesions combined with symptomatic remission. Therefore, more patients are currently receiving immunomodulators or biologics, frequently in addition to corticosteroids. Immunosuppression due to these therapies increases safety concerns, particularly regarding the risk of infections and malignancies. The available literature highlights how the combination of more than one of these therapies, especially if the combination includes corticosteroids, amplifies the risk of severe opportunistic infections. Otherwise, the infections described are mainly mild. Regarding malignancies, the overall risk associated with treatment appears non-significant in pediatric populations, but an appropriate benefit/risk assessment is recommended prior to the introduction of aggressive treatments such as immunomodulants and biologics. The background cancer risk related to the disease itself remains an issue. Protracted follow-up programs are needed, and the results from international multicenter registries are awaited to better understand the true risk related to therapy of these pediatric populations.

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Mortality and Cancer in Pediatric-Onset Inflammatory Bowel Disease: A Population-Based Study

Abstract: In this large pediatric population-based IBD cohort, mortality did not differ from that of the general population but there was a significant threefold increased risk of neoplasia.

Cited by 58 publications

References 43 publications

Inflammatory bowel disease in Turkish children

Inflammatory bowel disease in Turkish children

Diagnosis and management of inflammatory bowel disease in children

Long-Term Safety of Immunomodulators in Pediatric Inflammatory Diseases

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