Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry

Abstract

Background/Aims: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.Methods: This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.Results: A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, <i>P</i>< 0.01) but more L4a (47.3% vs. 29.6%, <i>P</i>< 0.01) and L3 (64.8% vs. 52.7%, <i>P</i>< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, <i>P</i>< 0.01).Conclusions: Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.

Long-term Disease Course of Crohn’s Disease: Changes in Disease Location, Phenotype, Activities, and Predictive Factors

“…lonic (L2) involvement compared with a European pediatric study based on a multicenter registry. 15 Thia et al 14 reported that only 20 patients (6.5%) had a change in disease extent between baseline and observation of their maximal extent. In a Korean retrospective study, disease location did not change from the initial diagnosis to the last followup evaluation in any patient.…”

Personalized medicine in inflammatory bowel disease: Perspectives on Asia

“…Current evidence on personalized medicine for patients with IBD has mainly been derived from studies involving patients of European ethnicities 7 . In Asian populations, the clinical features of IBD have been shown to differ in terms of clinical characteristics, therapeutic responses, and prognosis, most likely due to differences in environmental and genetic backgrounds 9,10 . Moreover, Asian healthcare systems and sociocultural backgrounds differ from those in Europe, as does the rapidly increasing incidence and prevalence of IBD in Asia 11 .…”

“…7 In Asian populations, the clinical features of IBD have been shown to differ in terms of clinical characteristics, therapeutic responses, and prognosis, most likely due to differences in environmental and genetic backgrounds. 9,10 Moreover, Asian healthcare systems and sociocultural backgrounds differ from those in Europe, as does the rapidly increasing incidence and prevalence of IBD in Asia. 11 Therefore, to a certain extent, personalized IBD therapy for people of Asian ethnicity may differ from that for people of European ethnicity.…”

Symptom Improvement of ulceRative colitis after an Induction dose of UStekinumab in Japanese clinical practice (SIRIUS), measured using patient-reported outcomes: a prospective observational study

“… 2 The incidence and prevalence of UC are increasing globally, including in Japan. Although UC can develop in younger children, 3 the age of onset increases rapidly from the late teens, with the peak occurring in the mid-20s for both men and women. 2 …”