This article is more than 5 years old. Information may no longer be current.
Improved treatment strategies reduce colectomy in pediatric ulcerative colitis
Click Here to Manage Email Alerts
The addition of biologics and using an early step-up approach to therapy has helped improve outcomes among children with ulcerative colitis over the last 7 years, according to a review by researchers from The Royal Children’s Hospital Melbourne in Australia.
“In the last 5 to 7 years, the treatment strategies and goals for UC have changed,” George Alex, FRACP, PhD, of the department of gastroenterology and clinical nutrition at the hospital, and colleagues wrote in Inflammatory Bowel Diseases. “The aim of our study was to evaluate how our clinical practice has changed since 2012 and to determine whether these changes in treatments have translated into an improvement in real-life disease outcomes, determined by the hospital admission rate, number of flares, and colectomy rate.”
In a retrospective review, researchers looked at patients from two different periods; group 1 (2005–2010; n = 71) and group 2 (2011–2016; n = 133). They compared baseline data, as well as overall colectomy rate, number of disease flares per year and number of hospital admissions per year between the two groups.
Compared with group 1, use of 5-ASA among patients in group 2 increased from 84.5% to 99.2% (P = .0007), while introduction of Remicade (infliximab, Janssen) and thiopurines occurred earlier in the disease course.
Although the median number of disease flares per year (group 1, 0.41 vs. group 2, 0.62) and number of admissions (0.3 vs. 0.21) did not change, the 2-year cumulative probability of colectomy decreased from 14% in group 1 to just 3% in group 2 (P = .02). The use of infliximab was independently associated with a reduction in colectomy (OR = 3.7; 95% CI, 1.1–11.7).
Alex and colleagues wrote that while their findings show some improvement in outcomes, better strategies are needed to take that success even further.
“The cause for this reduction is multifactorial, with the introduction of biologics and their optimal use possibly being an important contributor,” they concluded. “Additional strategies are required to reduce disease burden in terms of both number of disease flares and hospital admissions.” – by Alex Young
Disclosures: Healio Gastroenterology and Liver Disease could not confirm the authors’ relevant financial disclosures prior to publication.
Click Here to Manage Email Alerts