P137 Long-term outcome of paediatric-onset Crohn's disease: A population-based study

Peneau, A.; Salleron, Julia; Mathurin, Philippe; Lerebours, Éric; Jl, Dupas; Merle, V.; Cortot, A.; Mouterde, O.; Spyckerelle, C.; Djeddi, D.; Turck, Dominique; Peyrin-Biroulet, L; Colombel, J F; Gower‐Rousseau, Corinne

doi:10.1016/s1873-9946(12)60157-3

Cited by 6 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several recent large pediatric cohort studies provide invaluable insight on natural progression of pediatric onset Crohn's disease and confirm one in three children will have complicated CD at diagnosis, further doubling within 7-11 years from diagnosis [1][2][3]. The cumulative probability of intestinal resection is 30 % at 10 years and 50 % at 20 years from diagnosis [4].…”

Section: Introductionmentioning

confidence: 99%

Two-Year Outcomes After Exclusive Enteral Nutrition Induction Are Superior to Corticosteroids in Pediatric Crohn’s Disease Treated Early with Thiopurines

Grover

Lewindon

2015

Dig Dis Sci

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Two-Year Outcomes After Exclusive Enteral Nutrition Induction Are Superior to Corticosteroids in Pediatric Crohn’s Disease Treated Early with Thiopurines

Grover

Lewindon

2015

Dig Dis Sci

View full text Add to dashboard Cite

show abstract

“…In humans, a cohort study found a significant association between NOD2 risk alleles and increased abundance of Enterobacteriaceae [39]. In mice, NOD2 deficiency is also associated with ileal dysbiosis [40][41][42] but this is not consistently replicated [43,44]. NOD2 facilitates autophagic targeting of bacterial pathogens via binding to the autophagy protein ATG16L1, to be discussed later [22,45].…”

Section: Figure 12 Diagram Demonstrating Complex Interplay Of Genesmentioning

confidence: 99%

Section: D Natural History Of Paediatric Onset Cdmentioning

confidence: 99%

“…One in three children will have stricturing or fistulising disease behaviour at diagnosis with a cumulative probability of this doubling over the next 7-11 yrs (3,41). Anatomical extension of the disease is reported in 31-39% children during follow up (3,41). A recent French Paediatric cohort study reported a cumulative probability of one in three and one in two of coming to surgical resection at 10 and 20 years from diagnosis (41).…”

Section: D Natural History Of Paediatric Onset Cdmentioning

confidence: 99%

“…Anatomical extension of the disease is reported in 31-39% children during follow up (3,41). A recent French Paediatric cohort study reported a cumulative probability of one in three and one in two of coming to surgical resection at 10 and 20 years from diagnosis (41). A systematic review of paediatric studies with > 5…”

Section: D Natural History Of Paediatric Onset Cdmentioning

confidence: 99%

See 2 more Smart Citations

Exclusive enteral nutrition and mucosal healing in newly diagnosed children with Crohn’s disease: comparison of clinical parameters, biomarkers and mucosal microbiome between responders and non-responders

Grover¹

View full text Add to dashboard Cite

Therapies capable of inducing and maintaining endoscopic mucosal healing (MH) in Crohn's Disease (CD) are vital, as emerging data suggest that rapid early and sustained MH in CD is associated with less frequent clinical relapses, fewer hospitalisations and reduced intestinal resections (IR). (1) Use of Exclusive Enteral Nutrition (EEN) induction over corticosteroids (CS) in children with CD is associated with better early MH rates, but medium to long-term benefits are not well established.We hypothesised that early complete mucosal recovery after EEN induction therapy will lead to a greater relapse free survival and reduction in need for CS and anti-TNF use. The primary aim of thesis is to investigate benefits of EEN and early maintenance thiopurines (TP) use on early mucosal recovery, and its impact on the subsequent clinical course. Secondary aims were to relate clinical disease activity, biomarker response and mucosal microbiome characteristics of children with early mucosal recovery (responders) vs. mucosal non-responders to EEN.This thesis is comprised of five main studies.Study one: Importance of initial induction therapy on medium-term outcomes with routine early thiopurines (TP) use is not well documented in Paediatric CD; whether choice of EEN induction over CS reduces relapses, need for rescue CS or Infliximab (IFX) and intestinal resection (IR) remains unclear. In this retrospective study of 89 children with CD, completing induction therapy either with CS or EEN, we compared relapses, need for rescue CS or Infliximab (IFX) and intestinal resection (IR) over the first two years. Choice of EEN over CS in the setting of early optimised TP use was associated with reduced growth failure (7% vs. 26%, p=0.02), less CS dependency (7% vs. 43%, p=0.002) and a sustained response to IFX (86% vs. 68%, p=0.02). CS/IFX-free remission and IR were similar.

show abstract

Decrease in primary but not in secondary abdominal surgery for Crohn's disease: nationwide cohort study, 1990–2014

Kalman

Everhov

Nordenvall

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background Treatment of patients with Crohn's disease has evolved in recent decades, with increasing use of immunomodulatory medication since 1990 and biologicals since 1998. In parallel, there has been increased use of active disease monitoring. To what extent these changes have influenced the incidence of primary and repeat surgical resection remains debated. Methods In this nationwide cohort study, incident patients of all ages with Crohn's disease, identified in Swedish National Patient Registry between 1990 and 2014, were divided into five calendar periods of diagnosis: 1990–1995 and 1996–2000 with use of inpatient registries, 2001, and 2002–2008 and 2009–2014 with use of inpatient and outpatient registries. The cumulative incidence of first and repeat abdominal surgery (except closure of stomas), by category of surgical procedure, was estimated using the Kaplan–Meier method. Results Among 21 273 patients with Crohn's disease, the cumulative incidence of first abdominal surgery within 5 years of Crohn's disease diagnosis decreased continuously from 54·8 per cent in 1990–1995 to 40·4 per cent in 1996–2000 (P < 0·001), and again from 19·8 per cent in 2002–2008 to 17·3 per cent in 2009–2014 (P < 0·001). Repeat 5‐year surgery rates decreased from 18·9 per cent in 1990–1995 to 16·0 per cent in 1996–2000 (P = 0·009). After 2000, no further significant decreases were observed. Conclusion The 5‐year rate of surgical intervention for Crohn's disease has decreased significantly, but the rate of repeat surgery has remained stable despite the introduction of biological therapy.

show abstract

P137 Long-term outcome of paediatric-onset Crohn's disease: A population-based study

Cited by 6 publications

References 0 publications

Two-Year Outcomes After Exclusive Enteral Nutrition Induction Are Superior to Corticosteroids in Pediatric Crohn’s Disease Treated Early with Thiopurines

Two-Year Outcomes After Exclusive Enteral Nutrition Induction Are Superior to Corticosteroids in Pediatric Crohn’s Disease Treated Early with Thiopurines

Exclusive enteral nutrition and mucosal healing in newly diagnosed children with Crohn’s disease: comparison of clinical parameters, biomarkers and mucosal microbiome between responders and non-responders

Decrease in primary but not in secondary abdominal surgery for Crohn's disease: nationwide cohort study, 1990–2014

Contact Info

Product

Resources

About