Search

Summary Background Aims Methods Results Conclusions Previous studies highlighted a more extensive phenotype for paediatric‐onset than adult‐onset inflammatory bowel disease (IBD). However, most lacked long‐term follow‐up, and some were conducted before the era of biologics.The aim of this study is to compare disease characteristics and treatment exposures between paediatric‐onset and adult‐onset IBD.From a registry that periodically and uniformly retrieves demographics, disease characteristics/phenotype, and treatments, we compared the characteristics of paediatric‐onset (diagnosed at ≥6 and <18 years) and adult‐onset IBD, diagnosed during 2000–2022 and with ≥12 months follow‐up.Of the 2837 patients with Crohn's disease and 1332 with ulcerative colitis, 3316 had adult‐onset and 853 paediatric‐onset IBD. The median follow‐up was 6 years. Patients with paediatric‐onset presented with more extensive disease and received more intensified therapies, including biologics and JAK inhibitors than those with adult‐onset IBD. Paediatric‐onset ulcerative colitis showed a higher prevalence of E3 extensive colitis including pancolitis and a greater requirement for systemic steroids, immunomodulators, and biologics than adult‐onset ulcerative colitis. Paediatric‐onset versus adult‐onset Crohn's disease exhibited greater L3 ileocolonic involvement and perianal disease phenotype, and higher exposure to immunomodulators and biologics. Kaplan–Meier curve and Cox proportional hazards analyses showed significantly lower 15‐year biologic‐free survival from diagnosis among those with paediatric‐onset IBD than with adult‐onset IBD (p = <0.001), indicating greater and earlier use of biologics in the former.Paediatric‐onset presents with more extensive disease with higher exposures to immunomodulators and biologic therapies than adult‐onset IBD. [ABSTRACT FROM AUTHOR]

Summary: Background: Curcumin and QingDai (QD, Indigo) have been shown to be effective for treating active ulcerative colitis (UC). Aim: To evaluate the real‐world experience with the Curcumin–QingDai (CurQD) herbal combination to induce remission in active UC. Methods: A retrospec‑tive multicentre adult cohort study from five tertiary academic centres (2018–2022). Active UC was defined as a Simple Clinical Colitis Activity Index (SCCAI) ≥ 3. Patients were induced by CurQD. The primary outcome was clinical remission at weeks 8–12, defined as SCCAI ≤2 and a decrease ≥3 points from baseline. Secondary outcomes were clinical response (SCCAI decrease ≥3 points), corticosteroid‐free remission, faecal calprotectin (FC) response (reduction ≥50%), FC normalisation (FC ≤100 μg/g for patients with FC ≥300 μg/g at baseline), and safety. All outcomes were analysed for patients who were maintaining stable treatment. Results: Eighty‐eight patients were included; 50% were biologics/small molecules experienced, and 36.5% received ≥2 biologics/small molecules. Clinical remission was achieved in 41 (46.5%), and clinical response in 53 (60.2%). Median SCCAI decreased from 7 (IQR:5–9) to 2 (IQR:1–3); p < 0.0001. Of the 26 patients on corticosteroids at baseline, seven achieved corticosteroid‐free remission. Among 43 biologics/small molecules experienced patients, clinical remission was achieved in 39.5% and clinical response in 58.1%. FC normalisation and response were achieved in 17/29 and 27/33, respectively. Median FC decreased from 1000 μg/g (IQR:392–2772) at baseline to 75 μg/g (IQR:12–136) at the end of inductions (n = 30 patients with paired samples); p < 0.0001. No overt safety signals emerged. Conclusion: In this real‐world cohort, CurQD effectively induced clinical and biomarker remission in patients with active UC, including patients who were biologics/small molecules experienced. [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Yanai et al papers. To view these articles, visit https://doi.org/10.1111/apt.17538 and https://doi.org/10.1111/apt.17647 [ABSTRACT FROM AUTHOR]