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Early-onset IBD displayed extensive, aggressive phenotype
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Early-onset inflammatory bowel disease in children aged 5 years and younger is becoming more common than later-onset disease and displayed a more aggressive, extensive phenotype, according to recent study data.
Researchers collected data for 506 patients (mean age at diagnosis, 10.2 years; 46% female) with inflammatory bowel disease (IBD) from 14 Italian pediatric IBD centers. Data collection spanned Jan. 1, 2009, to April 22, 2013. Among the patients, 11% were aged 5 years and younger and considered the early-onset (EO) IBD group. Their phenotype and disease progression were compared with that of patients in the other groups: 50% of the cohort aged 12 to 18 years and 39% who were aged 6 to 11 years.
Crohn’s disease (CD) was most commonly diagnosed in the oldest age group (54%), whereas ulcerative colitis (UC) was observed more often in the two younger groups (59% among the EO-IBD arm; 53% for patients in the middle age group).
Within the three groups, 62% of the EO-IBD patients had pancolonic UC, compared with 38% in the middle group (P=.02) and 31% in the oldest group (P=.002). In the three groups, from youngest to oldest, only 11%, 15%, and 11% of patients, respectively, had a family history of IBD, which was not significant.
At the latest follow-up, the number of EO-IBD children receiving corticosteroids was greater compared with those in the oldest age group (P<.05).
“Our data suggest not only that the number of EO-IBD is steadily increasing, but also that the phenotype is extensive and aggressive already at the onset of the disease,” the researchers wrote. “The widespread location of CD and UC, notably in younger patients, may suggest the use of immunomodulatory and biologic agents early in the course of the disease.”
Disclosure: The researchers report no relevant financial disclosures.
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