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1. Development, Validation, and Evaluation of the Pediatric Inflammatory Crohn’s Magnetic Resonance Enterography Index From the ImageKids Study

Author

Focht, Gili, primary, Cytter-Kuint, Ruth, additional, Greer, Mary-Louise C., additional, Pratt, Li-Tal, additional, Castro, Denise A., additional, Church, Peter C., additional, Walters, Thomas D., additional, Hyams, Jeffrey, additional, Navon, Dan, additional, Martin de Carpi, Javier, additional, Ruemmele, Frank, additional, Russell, Richard K., additional, Gavish, Matan, additional, Griffiths, Anne M., additional, and Turner, Dan, additional

Published
2022
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2. Safety and Potential Efficacy of Escalating Dose of Ustekinumab in Pediatric Crohn Disease (the Speed-up Study): A Multicenter Study from the Pediatric IBD Porto Group of ESPGHAN

Author

Yerushalmy-Feler, Anat, primary, Pujol-Muncunill, Gemma, additional, Martin-de-Carpi, Javier, additional, Kolho, Kaija-Leena, additional, Levine, Arie, additional, Olbjørn, Christine, additional, Granot, Maya, additional, Bramuzzo, Matteo, additional, Rolandsdotter, Helena, additional, Mouratidou, Natalia, additional, Hradsky, Ondrej, additional, Scarallo, Luca, additional, Matar, Manar, additional, Rimon, Ramit Magen, additional, Rinawi, Firas, additional, Shalem, Tzippi, additional, Najajra, Hisham, additional, de Meij, Tim, additional, Aloi, Marina, additional, Rodríguez-Belvís, Marta Velasco, additional, Alvisi, Patrizia, additional, Schneider, Anna-Maria, additional, van Rheenen, Patrick, additional, Navas-López, Víctor Manuel, additional, Kiparissi, Fevronia, additional, Barrio, Josefa, additional, Turner, Dan, additional, and Cohen, Shlomi, additional

Published
2022
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3. Children included in randomised controlled trials of biologics in inflammatory bowel diseases do not represent the real‐world patient mix

Author

Atia, Ohad, primary, Pujol‐Muncunill, Gemma, additional, Navas‐López, Víctor Manuel, additional, Orlanski‐Meyer, Esther, additional, Ledder, Oren, additional, Lev‐Tzion, Raffi, additional, Focht, Gili, additional, Shteyer, Eyal, additional, Stein, Ronen, additional, Aloi, Marina, additional, Russell, Richard K., additional, Martin‐de‐Carpi, Javier, additional, and Turner, Dan, additional

Published
2022
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5. Helicobacter Pylori-Negative Chronic Gastritis in Children

Author

Assa, Amit, primary, Borrelli, Osvaldo, additional, Broekaert, Ilse, additional, Saccomani, Marco Deganello, additional, Dolinsek, Jernej, additional, Martin-de-Carpi, Javier, additional, Mas, Emmanuel, additional, Miele, Erasmo, additional, Sila, Sara, additional, Thomson, Mike, additional, Tzivinikos, Christos, additional, and Benninga, Marc A., additional

Published
2022
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6. Safety and effectiveness of vedolizumab in paediatric patients with inflammatory bowel disease: an observational multicentre Spanish study

Author

Garcia-Romero, Ruth, Martinez de Zabarte Fernandez, José Miguel, Pujol-Muncunill, Gemma, Donat-Aliaga, Ester, Segarra-Cantón, Oscar, Irastorza-Terradillos, Iñaki, Medina-Benitez, Enrique, Ruiz-Hernández, Carlos José, Carrillo-Palau, Marta, Ros-Arnal, Ignacio, Rodriguez-Martínez, Alejandro, Escartin-Madurga, Laura, Gutiérrez-Junquera, Carolina, Vicente-Santamaría, Saioa, Velasco Rodriguez-Belvis, Marta, Fernández-Fernández, Sonia, Alberto-Alonso, José Ramón, Montraveta, Montserrat, Torres-Peral, Ricardo, Navalon-Rubio, María, Navas-López, Víctor Manuel, and Martin de Carpi, Javier

Published
2021
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7. An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Author

Broekaert, Ilse Julia, primary, Borrelli, Osvaldo, additional, Dolinsek, Jernej, additional, Martin-de-Carpi, Javier, additional, Mas, Emmanuel, additional, Miele, Erasmo, additional, Pienar, Corina, additional, Ribes-Koninckx, Carmen, additional, Thomassen, Rut, additional, Thomson, Mike, additional, Tzivinikos, Christos, additional, and Benninga, Marc, additional

Published
2021
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8. Systematic review and meta‐analysis: the incidence and prevalence of paediatric coeliac disease across Europe

Author

Roberts, Stephen E., primary, Morrison‐Rees, Sian, additional, Thapar, Nikhil, additional, Benninga, Marc A., additional, Borrelli, Osvaldo, additional, Broekaert, Ilse, additional, Dolinsek, Jernej, additional, Martin‐de‐Carpi, Javier, additional, Mas, Emmanuel, additional, Miele, Erasmo, additional, Pienar, Corina, additional, Ribes‐Koninckx, Carmen, additional, Thomassen, Rut A., additional, Thomson, Mike, additional, Tzivinikos, Christos, additional, Thorne, Kymberley, additional, John, Ann, additional, and Williams, John G., additional

Published
2021
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9. Dual Biologic or Small Molecule Therapy in Refractory Pediatric Inflammatory Bowel Disease (DOUBLE-PIBD): A Multicenter Study from the Pediatric IBD Porto Group of ESPGHAN.

Author

Yerushalmy-Feler, Anat, Olbjorn, Christine, Kolho, Kaija-Leena, Aloi, Marina, Musto, Francesca, Martin-de-Carpi, Javier, Lozano-Ruf, Ana, Yogev, Dotan, Matar, Manar, Scarallo, Luca, Bramuzzo, Matteo, Ridder, Lissy de, Kang, Ben, Norden, Christoph, Wilson, David C, Tzivinikos, Christos, Turner, Dan, and Cohen, Shlomi

Published
2024
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11. Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

Author

Orlanski-Meyer, Esther, primary, Aardoom, Martine, additional, Ricciuto, Amanda, additional, Navon, Dan, additional, Carman, Nicholas, additional, Aloi, Marina, additional, Bronsky, Jiri, additional, Däbritz, Jan, additional, Dubinsky, Marla, additional, Hussey, Séamus, additional, Lewindon, Peter, additional, Martin De Carpi, Javier, additional, Navas-López, Víctor Manuel, additional, Orsi, Marina, additional, Ruemmele, Frank M., additional, Russell, Richard K., additional, Veres, Gabor, additional, Walters, Thomas D., additional, Wilson, David C., additional, Kaiser, Thomas, additional, de Ridder, Lissy, additional, Griffiths, Anne, additional, and Turner, Dan, additional

Published
2021
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14. Complicated Disease and Response to Initial Therapy Predicts Early Surgery in Paediatric Crohn’s Disease: Results From the Porto Group GROWTH Study

Author

Levine, Arie, primary, Chanchlani, Neil, additional, Hussey, Seamus, additional, Ziv-Baran, Tomer, additional, Escher, Johanna C, additional, Amil Dias, Jorge, additional, Veres, Gabor, additional, Koletzko, Sibylle, additional, Turner, Dan, additional, Kolho, Kaija-Leena, additional, Paerregaard, Anders, additional, Staiano, Annamaria, additional, Lionetti, Paolo, additional, Nuti, Federica, additional, Sladek, Malgorata, additional, Shaoul, Ron, additional, Lazowska-Prezeorek, Isabella, additional, Martin de Carpi, Javier, additional, Sigall Boneh, Rotem, additional, Pfeffer Gik, Tamar, additional, Cohen-Dolev, Noa, additional, and Russell, Richard K, additional

Published
2019
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15. Pediatric Magnet Ingestion, Diagnosis, Management, and Prevention: A European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Position Paper

Author

Nugud, A A, Tzivinikos, Christos, Assa, Amit, Borrelli, Osvaldo, Broekaert, Ilse, Martin-de-Carpi, Javier, Deganello Saccomani, Marco, Dolinsek, Jernej, Homan, M, Mas, Emmanuel, Miele, Erasmo, Thomson, Mike, Benninga, Marc A, Nugud, A A, Tzivinikos, Christo, Assa, Amit, Borrelli, Osvaldo, Broekaert, Ilse, Martin-de-Carpi, Javier, Deganello Saccomani, Marco, Dolinsek, Jernej, Homan, M, Mas, Emmanuel, Miele, Erasmo, Thomson, Mike, and Benninga, Marc A

Abstract

Magnet ingestion is a special category of foreign body ingestion associated with high levels of morbidity and mortality worldwide, particularly if it is associated with staggered ingestion of multiple magnets or with simultaneous ingestion of other metallic foreign bodies, especially button batteries. A special category of magnet ingestion is the ingestion of earth magnets, which have higher levels of magnetism and therefore, potentially, carries a worse outcome. Legislative bodies, scientific Societies and community-led initiatives have been implemented worldwide with the aim of mitigating the effects of this growing, yet avoidable potential medical emergency. A scoping literature review summarized epidemiology, diagnosis, management, and prevention, including an algorithm for the diagnosis and management of magnet ingestion is presented and compared to previously published reviews and position papers (North American Society of Pediatric Gastroenterology, Hepatology and Nutrition, National Poison Center, Royal College of Emergency Medicine). The main emphasis of the algorithm is on identification of staggered/multiple magnet ingestion, and early joint gastroenterology and surgical consultation and management.

Published
2023

16. Designing clinical trials in paediatric inflammatory bowel diseases: a PIBDnet commentary

Author

Turner, Dan, primary, Griffiths, Anne M, additional, Wilson, David, additional, Mould, Diane R, additional, Baldassano, Robert N, additional, Russell, Richard K, additional, Dubinsky, Marla, additional, Heyman, Melvin B, additional, de Ridder, Lissy, additional, Hyams, Jeffrey, additional, Martin de Carpi, Javier, additional, Conklin, Laurie, additional, Faubion, William A, additional, Koletzko, Sibylle, additional, Bousvaros, Athos, additional, and Ruemmele, Frank M, additional

Published
2019
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17. Response to treatment is more important than disease severity at diagnosis for prediction of early relapse in new-onset paediatric Crohn’s disease

Author

Ziv-Baran, Tomer, primary, Hussey, Séamus, additional, Sladek, Malgorzata, additional, Amil Dias, Jorge, additional, Martin de Carpi, Javier, additional, Miele, Erasmo, additional, Veres, Gabor, additional, Lionetti, Paolo, additional, Koletzko, Sibylle, additional, Nuti, Federica, additional, Paerregaard, Anders, additional, Kolho, Kaija-Leena, additional, Russell, Richard K., additional, Shaoul, Ron, additional, Weiner, Dror, additional, Sigall Boneh, Rotem, additional, Escher, Johanna, additional, Finnby, Lenne, additional, Turner, Dan, additional, and Levine, Arie, additional

Published
2018
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18. Corrigendum: Vedolizumab in Paediatric Inflammatory Bowel Disease: A Retrospective Multi-Centre Experience From the Paediatric IBD Porto Group of ESPGHAN

Author

Ledder, Oren, primary, Assa, Amit, additional, Levine, Arie, additional, Escher, Johanna C, additional, de Ridder, Lissy, additional, Ruemmele, Frank, additional, Shah, Neil, additional, Shaoul, Ron, additional, Wolters, Victorien M, additional, Rodrigues, Astor, additional, Uhlig, Holm H, additional, Posovszky, Carsten, additional, Kolho, Kaija-Leena, additional, Jakobsen, Christian, additional, Cohen, Shlomi, additional, Shouval, Dror S, additional, de Meij, Tim, additional, Martin-de-Carpi, Javier, additional, Richmond, Lisa, additional, Bronsky, Jiri, additional, Friedman, Mira, additional, and Turner, Dan, additional

Published
2018
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21. Vedolizumab in Paediatric Inflammatory Bowel Disease: A Retrospective Multi-Centre Experience From the Paediatric IBD Porto Group of ESPGHAN

Author

Ledder, Oren, primary, Assa, Amit, additional, Levine, Arie, additional, Escher, Johanna C, additional, de Ridder, Lissy, additional, Ruemmele, Frank, additional, Shah, Neil, additional, Shaoul, Ron, additional, Wolters, Victorien M, additional, Rodrigues, Astor, additional, Uhlig, Holm H, additional, Posovszky, Carsten, additional, Kolho, Kaija-Leena, additional, Jakobsen, Christian, additional, Cohen, Shlomi, additional, Shouval, Dror S, additional, de Meij, Tim, additional, Martin-de-Carpi, Javier, additional, Richmond, Lisa, additional, Bronsky, Jiri, additional, Friedman, Mira, additional, and Turner, Dan, additional

Published
2017
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23. Surgical Management of Crohn Disease in Children: Guidelines From the Paediatric IBD Porto Group of ESPGHAN

Author

Amil-Dias, Jorge, primary, Kolacek, Sanja, additional, Turner, Dan, additional, Pærregaard, Anders, additional, Rintala, Risto, additional, Afzal, Nadeem A., additional, Karolewska-Bochenek, Katarzyna, additional, Bronsky, Jiri, additional, Chong, Sonny, additional, Fell, John, additional, Hojsak, Iva, additional, Hugot, Jean-Pierre, additional, Koletzko, Sibylle, additional, Kumar, Devinder, additional, Lazowska-Przeorek, Izabella, additional, Lillehei, Craig, additional, Lionetti, Paolo, additional, Martin-de-Carpi, Javier, additional, Pakarinen, Mikko, additional, Ruemmele, Frank M., additional, Shaoul, Ron, additional, Spray, Christine, additional, Staiano, Annamaria, additional, Sugarman, Ian, additional, Wilson, David C., additional, Winter, Harland, additional, and Kolho, Kaija-Leena, additional

Published
2017
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24. Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn’s Disease: Results From theGROWTH CDStudy

Author

Cohen-Dolev, Noa, primary, Sladek, Malgorata, additional, Hussey, Seamus, additional, Turner, Dan, additional, Veres, Gabor, additional, Koletzko, Sibylle, additional, Martin de Carpi, Javier, additional, Staiano, Annamaria, additional, Shaoul, Ron, additional, Lionetti, Paolo, additional, Amil Dias, Jorge, additional, Paerregaard, Anders, additional, Nuti, Federica, additional, Pfeffer Gik, Tamar, additional, Ziv-Baran, Tomer, additional, Ben Avraham Shulman, Sivan, additional, Sarbagili Shabat, Chen, additional, Sigall Boneh, Rotem, additional, Russell, Richard K, additional, and Levine, Arie, additional

Published
2017
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25. ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents

Author

Levine, Arie, primary, Koletzko, Sibylle, additional, Turner, Dan, additional, Escher, Johanna C., additional, Cucchiara, Salvatore, additional, de Ridder, Lissy, additional, Kolho, Kaija-Leena, additional, Veres, Gabor, additional, Russell, Richard K., additional, Paerregaard, Anders, additional, Buderus, Stephan, additional, Greer, Mary-Louise C., additional, Dias, Jorge A., additional, Veereman-Wauters, Gigi, additional, Lionetti, Paolo, additional, Sladek, Malgorzata, additional, Martin de Carpi, Javier, additional, Staiano, Annamaria, additional, Ruemmele, Frank M., additional, and Wilson, David C., additional

Published
2014
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26. Comparison of Outcomes Parameters for Induction of Remission in New Onset Pediatric Crohnʼs Disease

Author

Levine, Arie, primary, Turner, Dan, additional, Pfeffer Gik, Tamar, additional, Amil Dias, Jorge, additional, Veres, Gabor, additional, Shaoul, Ron, additional, Staiano, Annamaria, additional, Escher, Johanna, additional, Kolho, Kaija Leena, additional, Paerregaard, Anders, additional, Martin de Carpi, Javier, additional, Veereman Wauters, Gigi, additional, Koletzko, Sibylle, additional, Shevah, Orit, additional, Finnby, Lenne, additional, and Sladek, Malgorzata, additional

Published
2014
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27. Malignancy and Mortality in Pediatric Patients with Inflammatory Bowel Disease

Author

de Ridder, Lissy, primary, Turner, Dan, additional, Wilson, David C., additional, Koletzko, Sibylle, additional, Martin-de-Carpi, Javier, additional, Fagerberg, Ulrika L., additional, Spray, Christine, additional, Sladek, Malgorzata, additional, Shaoul, Ron, additional, Roma-Giannikou, Eleftheria, additional, Bronsky, Jiri, additional, Serban, Daniela E., additional, Cucchiara, Salvatore, additional, Veres, Gabor, additional, Ruemmele, Frank M., additional, Hojsak, Iva, additional, Kolho, Kaija L., additional, Davies, Ieuan H., additional, Aloi, Marina, additional, Lionetti, Paolo, additional, Veereman-Wauters, Gigi, additional, Braegger, Christian P., additional, Trindade, Eunice, additional, Wewer, Anne V., additional, Hauer, Almuthe, additional, and Levine, Arie, additional

Published
2014
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29. Efectividad y seguridad en nuestro entorno de adalimumab como tratamiento anti-TNF de primera linea en niños con enfermedad de Crohn

Author

Navas-López, Víctor Manuel, Pujol Muncunill, Gemma, Llerena, Enrique, Navalón Rubio, María, Gil-Ortega, David, Varea-Calderón, Vicente, Sierra Salinas, Carlos, and Martin-de-Carpi, Javier

Abstract

Adalimumab (ADA), anticuerpo anti-TNF-α monoclonal recombinante de origen humano, generalmente se emplea como tratamiento de segunda línea en niños con enfermedad de Crohn (EC) que no han respondido o han perdido respuesta a infliximab (IFX). En las series publicadas más del 70% de los pacientes habían sido tratados inicialmente con IFX. Los datos sobre la eficacia a corto y a largo plazo de ADA en pacientes naïvea anti-TNF son muy limitados. El objetivo del presente estudio es describir nuestra experiencia con ADA como tratamiento anti-TNF de primera línea en niños con EC.

Published
2024
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30. Surgical Management of Crohn Disease in Children

Author

Amil-Dias, Jorge, Kolacek, Sanja, Turner, Dan, Pærregaard, Anders, Rintala, Risto, Afzal, Nadeem A., Karolewska-Bochenek, Katarzyna, Bronsky, Jiri, Chong, Sonny, Fell, John, Hojsak, Iva, Hugot, Jean-Pierre, Koletzko, Sibylle, Kumar, Devinder, Lazowska-Przeorek, Izabella, Lillehei, Craig, Lionetti, Paolo, Martin-de-Carpi, Javier, Pakarinen, Mikko, Ruemmele, Frank M., Shaoul, Ron, Spray, Christine, Staiano, Annamaria, Sugarman, Ian, Wilson, David C., Winter, Harland, and Kolho, Kaija-Leena

Subjects
ibd, digestive system diseases
Abstract

Surgical Management of Crohn Disease in Children

Published
2017

31. Designing clinical trials in paediatric inflammatory bowel diseases: a PIBDnet commentary

Author

Turner, Dan, Griffiths, Anne M, Wilson, David, Mould, Diane R, Baldassano, Robert N, Russell, Richard K, Dubinsky, Marla, Heyman, Melvin B, de Ridder, Lissy, Hyams, Jeffrey, Martin de Carpi, Javier, Conklin, Laurie, Faubion, William A, Koletzko, Sibylle, Bousvaros, Athos, and Ruemmele, Frank M

Abstract

IntroductionThe optimal trial design for assessing novel therapies in paediatric IBD (PIBD) is a subject of intense ongoing global discussions and debate among the different stakeholders. However, there is a consensus that the current situation in which most medications used in children with IBD are prescribed as off-label without sufficient paediatric data is unacceptable. Shortening the time lag between adult and paediatric approval of drugs is of the upmost importance. In this position paper we aimed to provide guidance from the global clinical research network (Pediatric Inflammatory Bowel Disease Network, PIBDnet) for designing clinical trials in PIBD in order to facilitate drug approval for children.MethodsA writing group has been established by PIBDnet and topics were assigned to different members. After an iterative process of revisions among the writing group and one face-to-face meeting, all statements have reached consensus of >80% as defined a priori. Next, all core members of PIBDnet voted on the statements, reaching consensus of >80% on all statements. Comments from the members were incorporated in the text.ResultsThe commentary includes 18 statements for guiding data extrapolation from adults, eligibility criteria to PIBD trials, use of placebo, dosing, endpoints and recommendations for feasible trials. Controversial issues have been highlighted in the text.ConclusionThe viewpoints expressed in this paper could assist planning clinical trials in PIBD which are both of high quality and ethical, while remaining pragmatic.

Published
2020
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32. Helicobacter pylori-negative Chronic Gastritis in Children

Author

Amit Assa, Osvaldo Borrelli, Ilse Broekaert, Marco Deganello Saccomani, Jernej Dolinsek, Javier Martin-de-Carpi, Emmanuel Mas, Erasmo Miele, Sara Sila, Mike Thomson, Christos Tzivinikos, Marc A. Benninga, Pediatric surgery, Paediatric Gastroenterology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), Assa, Amit, Borrelli, Osvaldo, Broekaert, Ilse, Saccomani, Marco Deganello, Dolinsek, Jernej, Martin-de-Carpi, Javier, Mas, Emmanuel, Miele, Erasmo, Sila, Sara, Thomson, Mike, Tzivinikos, Christo, and Benninga, Marc A

Subjects
Adult, Cross-Sectional Studies, Helicobacter pylori, Gastritis, Pediatrics, Perinatology and Child Health, Eosinophilia, Gastroenterology, Humans, Child, Enteritis, Helicobacter Infections
Abstract

OBJECTIVES: To systematically review the current evidence on Helicobacter pylori-negative chronic gastritis including natural history, available therapies and outcomes. METHODS: Articles providing data on the prevalence, treatment or outcomes of Helicobacter pylori-negative gastritis were identified through a systematic search in the MEDLINE and EMBASE databases. All original research articles from human studies until October 31, 2021, were included. RESULTS: A total of 54 studies were included consisted of eosinophilic gastritis (n = 9), autoimmune gastritis (n = 11), collagenous gastritis (n = 16), focally enhanced gastritis (n = 6), lymphocytic gastritis (n = 5) and other causes including idiopathic gastritis and chronic renal failure related (n = 7). Most of the included studies were either cross-sectional or longitudinal cohorts except for collagenous gastritis, which mainly included case reports and case series. The prevalence of paediatric eosinophilic gastritis ranges between 5 and 7/100,000 and patients have generally favourable outcome with 50% to 70% clinical and histological response to either corticosteroids or elimination diets. Autoimmune gastritis and collagenous gastritis are extremely rare entities, commonly present with refractory iron deficiency anaemia, while lymphocytic gastritis is relatively common (10%-45%) in children with coeliac disease. Data on treatments and outcomes of autoimmune, collagenous, and focally enhanced gastritis are lacking with limited data implying poor response to therapy in the former 2 diagnoses. CONCLUSIONS: Helicobacter pylori-negative gastritis is uncommonly reported, mainly in small cohorts, mixed adult-paediatric cohorts or as sporadic case reports. As common symptoms are not specific, thus not always result in an endoscopic evaluation, the true prevalence of these distinct disorders may be underestimated, and thus under reported.

Published
2022

33. Systematic review and meta‐analysis: the incidence and prevalence of paediatric coeliac disease across Europe

Author

Osvaldo Borrelli, Christos Tzivinikos, Corina Pienar, Carmen Ribes-Koninckx, John Williams, Kym Thorne, Ilse Broekaert, Stephen E. Roberts, Javier Martín-de-Carpi, Ann John, Emmanuel Mas, Nikhil Thapar, Marc A. Benninga, Rut Anne Thomassen, Mike Thomson, Jernej Dolinsek, Sian Morrison-Rees, Erasmo Miele, Roberts, Stephen E, Morrison-Rees, Sian, Thapar, Nikhil, Benninga, Marc A, Borrelli, Osvaldo, Broekaert, Ilse, Dolinsek, Jernej, Martin-de-Carpi, Javier, Mas, Emmanuel, Miele, Erasmo, Pienar, Corina, Ribes-Koninckx, Carmen, Thomassen, Rut A, Thomson, Mike, Tzivinikos, Christo, Thorne, Kymberley, John, Ann, Williams, John G, Swansea University, Great Ormond Street Hospital for Children [London] (GOSH), University College of London [London] (UCL), Children’s Health Queensland [Brisbane] (CHQ), University of Amsterdam [Amsterdam] (UvA), University Hospital of Cologne [Cologne], University medical centre Maribor (UKC Maribor), Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), 'Federico II' University of Naples Medical School, Victor Babeş University of Medicine and Pharmacy (UMFT), Hospital Universitari i Politècnic La Fe, Oslo University Hospital [Oslo], University of Sheffield [Sheffield], Al Jalila Children's Specialty Hospital, and European Society for Paediatric Gastroenterology Hepatology and Nutrition

Subjects
Pediatrics, medicine.medical_specialty, MEDLINE, Age at diagnosis, Cochrane Library, Asymptomatic, Coeliac disease, Serology, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Prevalence, medicine, Humans, Pharmacology (medical), Child, Aged, Autoantibodies, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Hepatology, business.industry, Incidence, Incidence (epidemiology), Gastroenterology, Infant, medicine.disease, 3. Good health, Europe, Celiac Disease, Child, Preschool, Meta-analysis, 030211 gastroenterology & hepatology, medicine.symptom, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: Coeliac disease is one of the most prevalent immune-mediated gastrointestinal disorders in children. Aim: To review the incidence and prevalence of paediatric coeliac disease, and their trends, regionally across Europe, overall and according to age at diagnosis. Methods: Systematic review and meta-analysis from January 1, 1950 to December 31, 2019, based on PubMed, CINAHL and the Cochrane Library, searches of grey literature and websites and hand searching of reference lists. A total of 127 eligible studies were included. Results: The prevalence of previously undiagnosed coeliac disease from screening surveys (histology based) ranged from 0.10% to 3.03% (median = 0.70%), with a significantly increasing annual trend (P = 0.029). Prevalence since 2000 was significantly higher in northern Europe (1.60%) than in eastern (0.98%), southern (0.69%) and western (0.60%) Europe. Large increases in the incidence of diagnosed coeliac disease across Europe have reached 50 per 100 000 person-years in Scandinavia, Finland and Spain. The median age at diagnosis increased from 1.9 years before 1990 to 7.6 since 2000. Larger increases in incidence were found in older age groups than in infants and ages

Published
2021

34. An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology

Author

Rut Ann Thomassen, Jernej Dolinsek, Carmen Ribes-Koninckx, Erasmo Miele, Christos Tzivinikos, Corina Pienar, Javier Martín-de-Carpi, Emmanuel Mas, Marc A. Benninga, Osvaldo Borrelli, Ilse Broekaert, Mike Thomson, University Hospital of Cologne [Cologne], Great Ormond Street Hospital for Children [London] (GOSH), University medical centre Maribor (UKC Maribor), Hospital Sant Joan de Déu [Barcelona], Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), 'Federico II' University of Naples Medical School, Victor Babeş University of Medicine and Pharmacy (UMFT), Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe, Oslo University Hospital [Oslo], Sheffield Children's NHS Foundation Trust, Al Jalila Children's Specialty Hospital, VU University Medical Center [Amsterdam], SEGUIN, Nathalie, Broekaert, Ilse Julia, Borrelli, Osvaldo, Dolinsek, Jernej, Martin-de-Carpi, Javier, Mas, Emmanuel, Miele, Erasmo, Pienar, Corina, Ribes-Koninckx, Carmen, Thomassen, Rut, Thomson, Mike, Tzivinikos, Christo, Benninga, Marc, and Hospital Universitari i Politècnic La Fe

Subjects
medicine.medical_specialty, Malabsorption, Consensus, Carbohydrate malabsorption, 030309 nutrition & dietetics, MEDLINE, carbohydrate malabsorption, small intestinal bacterial overgrowth, Helicobacter pylori infection, Helicobacter Infections, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, children, Internal medicine, Small intestinal bacterial overgrowth, medicine, breath testing, Humans, Intensive care medicine, Exocrine pancreatic insufficiency, Child, Children, 0303 health sciences, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Fat malabsorption, Breath testing, Systematic review, Breath Tests, Pediatrics, Perinatology and Child Health, Position paper, 030211 gastroenterology & hepatology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Systematic Reviews as Topic
Abstract

International audience; Objectives: Given a lack of a systematic approach to the use of breath testing in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimise its utility and safety. Methods: Nine clinical questions regarding methodology, interpretation, and specific indications of breath testing and treatment of carbohydrate malabsorption were addressed by members of the Gastroenterology Committee (GIC) of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). A systematic literature search was performed from 1983 to 2020 using PubMed, the MEDLINE and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes. During a consensus meeting, all recommendations were discussed and finalised. In the absence of evidence from randomised controlled trials, recommendations reflect the expert opinion of the authors. Results: A total of 22 recommendations were voted on using the nominal voting technique. At first, recommendations on prerequisites and preparation for as well as on interpretation of breath tests are given. Then, recommendations on the usefulness of H2-lactose breath testing, H2-fructose breath testing as well as of breath tests for other types of carbohydrate malabsorption are provided. Furthermore, breath testing is recommended to diagnose small intestinal bacterial overgrowth (SIBO), to control for success of Helicobacter pylori eradication therapy and to diagnose and monitor therapy of exocrine pancreatic insufficiency, but not to estimate oro-caecal transit time (OCTT) or to diagnose and follow-up on celiac disease. Conclusions: Breath tests are frequently used in paediatric gastroenterology mainly assessing carbohydrate malabsorption, but also in the diagnosis of small intestinal overgrowth, fat malabsorption, H. pylori infection as well as for measuring gastrointestinal transit times. Interpretation of the results can be challenging and in addition, pertinent symptoms should be considered to evaluate clinical tolerance.

Published
2021

35. Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn’s Disease: Results From theGROWTH CDStudy

Author

Ron Shaoul, Malgorata Sladek, Sibylle Koletzko, Jorge Amil Dias, Javier Martín de Carpi, Annamaria Staiano, Rotem Sigall Boneh, Gábor Veres, Federica Nuti, Arie Levine, N. Cohen-Dolev, Seamus Hussey, Sivan Ben Avraham Shulman, Dan Turner, Tomer Ziv-Baran, Richard K. Russell, Anders Paerregaard, Tamar Pfeffer Gik, Paolo Lionetti, Chen Sarbagili Shabat, Cohen-Dolev, Noa, Sladek, Malgorata, Hussey, Seamu, Turner, Dan, Veres, Gabor, Koletzko, Sibylle, Martin de Carpi, Javier, Staiano, Annamaria, Shaoul, Ron, Lionetti, Paolo, Amil Dias, Jorge, Paerregaard, Ander, Nuti, Federica, Pfeffer Gik, Tamar, Ziv-Baran, Tomer, Ben Avraham Shulman, Sivan, Sarbagili Shabat, Chen, Sigall Boneh, Rotem, Russell, Richard K, and Levine, Arie

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, Constriction, Pathologic, Severity of Illness Index, Gastroenterology, Inflammatory bowel disease, 03 medical and health sciences, Enteral Nutrition, 0302 clinical medicine, Crohn Disease, Adrenal Cortex Hormones, Recurrence, Internal medicine, Severity of illness, medicine, Humans, Rectal Fistula, Prospective Studies, 030212 general & internal medicine, Child, Propensity Score, Prospective cohort study, Biological Products, Crohn's disease, business.industry, Remission Induction, Mean age, General Medicine, medicine.disease, Abscess, Body Height, Treatment Outcome, Parenteral nutrition, Propensity score matching, Female, 030211 gastroenterology & hepatology, business, Complication
Abstract

Background: Exclusive enteral nutrition [EEN] and corticosteroids [CS] induce similar rates of remission in mild to moderate paediatric Crohn's disease [CD], but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long-term outcomes. Methods: We prospectively followed newly diagnosed children aged < 17 years, with mild to moderate CD at baseline, for 2 years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks. Remission, relapses, complications [fibrostenotic disease, penetrating disease, and active perianal disease] and growth were recorded throughout the study. A propensity score analysis was performed. Results: A total of 147 children [mean age 12.9 +/- 3.2 years], treated by EEN [n = 60] or CS [n = 87] were included. New complications developed in 13.7% of CS [12/87] versus 11.6% of EEN [7/60], p = 0.29. Remission was achieved in 41/87 [47%] in CS and 38/60 [63%] EEN, p = 0.036. Median time to relapse did not differ [14.4 +/- 1 months with CS, 16.05 +/- 1.1 EEN, p = 0.28]. Mean height Z scores decreased from Week 0 to Week 78 with CS [-0.34 +/- 1.1 to -0.51 +/- 1.2, p = 0.01], but not with EEN [-0.32 +/- 1.1 to -0.22 +/- 0.9, p = 0.56]. In a propensity score analysis, EEN was superior to CS for inducing remission [p = 0.05] and trended to superiority for height Z score [p = 0.055]. Conclusions: Use of EEN was associated with higher remission rates and a trend toward better growth but with similar relapse and complication rates in new-onset mild to moderate paediatric CD.

Published
2017

36. Response to treatment is more important than disease severity at diagnosis for prediction of early relapse in new-onset paediatric Crohn’s disease

Author

Gábor Veres, Jorge Amil Dias, Anders Paerregaard, Johanna C. Escher, Dror Weiner, Dan Turner, Richard K. Russell, Erasmo Miele, Javier Martín de Carpi, Rotem Sigall Boneh, Tomer Ziv-Baran, Kaija-Leena Kolho, Sibylle Koletzko, Ron Shaoul, Seamus Hussey, Arie Levine, Federica Nuti, Malgorzata Sladek, Paolo Lionetti, L. Finnby, Ziv-Baran, Tomer, Hussey, Séamu, Sladek, Malgorzata, Amil Dias, Jorge, Martin de Carpi, Javier, Miele, Erasmo, Veres, Gabor, Lionetti, Paolo, Koletzko, Sibylle, Nuti, Federica, Paerregaard, Ander, Kolho, Kaija-Leena, Russell, Richard K., Shaoul, Ron, Weiner, Dror, Sigall Boneh, Rotem, Escher, Johanna, Finnby, Lenne, Turner, Dan, Levine, Arie, and Pediatrics

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, Disease, Klinikai orvostudományok, Logistic regression, Severity of Illness Index, Feces, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Predictive Value of Tests, Recurrence, Internal medicine, Severity of illness, medicine, Humans, Immunologic Factors, Pharmacology (medical), Prospective Studies, Child, Prospective cohort study, Crohn's disease, Hepatology, business.industry, Remission Induction, Gastroenterology, Orvostudományok, medicine.disease, Faecal calprotectin, Treatment Outcome, 030104 developmental biology, Child, Preschool, Predictive value of tests, Female, 030211 gastroenterology & hepatology, Calprotectin, business, Leukocyte L1 Antigen Complex, Biomarkers
Abstract

Background Paediatric Crohn's disease is characteried by frequently relapsing disease which may lead to hospitalisations and complications. Aim To develop predictive models for early relapse following first remission. Methods The GROWTH CD prospective inception cohort was designed to predict risk for early disease relapse and poor outcomes. Newly diagnosed children underwent endoscopies and imaging. They were phenotyped and followed at scheduled visits through 78 weeks for relapses. Twenty-eight dichotomous and continuous variables were assessed at baseline and week 12, including phenotype, inflammatory markers, disease activity (PCDAI) and other markers. Clinical relapses defined as PCDAI >10 after remission were recorded using a relapse form. Logistic regression & risk modelling was performed. Results We enrolled 282 eligible patients of whom 178 (63.6%) patients achieved steroid free remission by week 12. Disease complications developed in 22/76(29%) of patients with relapse compared to 20/206 (9.7%) without relapse (P = 0.01). Multivariable analysis demonstrated that while variables from age/gender at diagnosis were not predictive, week 12 variables including PCDAI >5 (P = 0.02), CRP >20 mg/L (P = 0.02), and faecal calprotectin >400 µg/g (P = 0.03) as optimal cut-offs were associated with increased risk of relapse. A prediction model for patients in remission including gender, age, week 12 PCDAI, calprotectin and CRP had sensitivity 43%, specificity 92%, PPV 78%, NPV 71% for relapse. Conclusions Early relapses were associated with a higher risk for disease complications at followup. Relapse prediction based on week 12 disease activity or inflammation is superior to prediction using data from diagnosis.

Published
2018

37. Surgical Management of Crohn Disease in Children: Guidelines From the Paediatric IBD Porto Group of ESPGHAN

Author

Mikko P. Pakarinen, Frank M. Ruemmele, Javier Martín-de-Carpi, Christine Spray, Iva Hojsak, Ian D. Sugarman, Sanja Kolaček, Dan Turner, Annamaria Staiano, Sibylle Koletzko, Ron Shaoul, Sonny K. F. Chong, Paolo Lionetti, Devinder Kumar, John Fell, Harland S. Winter, Anders Paerregaard, Risto Rintala, David C. Wilson, Jean-Pierre Hugot, Nadeem A. Afzal, Craig W. Lillehei, Kaija-Leena Kolho, Izabella Lazowska-Przeorek, Katarzyna Karolewska-Bochenek, Jiri Bronsky, Jorge Amil-Dias, Amil Dias, Jorge, Kolacek, Sanja, Turner, Dan, Pærregaard, Ander, Rintala, Risto, Afzal, Nadeem Ahmad, Karolewska Bochenek, Katarzyna, Bronsky, Jiri, Chong, Sonny, Fell, John, Hojsak, Iva, Hugot, Jean Pierre, Koletzko, Sibylle, Kumar, Devinder, Lazowska Przeorek, Izabella, Lillehei, Craig, Lionetti, Paolo, Martin de Carpi, Javier, Pakarinen, Mikko, Ruemmele, Frank M, Shaoul, Ron, Spray, Christine, Staiano, Annamaria, Sugarman, Ian, Wilson, David C, Winter, Harland, and Kolho, Kaija Leena

Subjects
medicine.medical_specialty, Placebo-controlled study, MEDLINE, Anti-Inflammatory Agents, Inflammatory bowel disease, Perioperative Care, law.invention, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, Crohn Disease, law, Recurrence, Intestine, Small, Secondary Prevention, Medicine, Humans, Elective surgery, Intensive care medicine, Child, Colectomy, business.industry, Incidence (epidemiology), Patient Selection, Anastomosis, Surgical, Gastroenterology, Perioperative, medicine.disease, Surgery, Biological Therapy, Chemotherapy, Adjuvant, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, 030211 gastroenterology & hepatology, business, Elective Surgical Procedure, Immunosuppressive Agents
Abstract

The incidence of Crohn disease (CD) has been increasing and surgery needs to be contemplated in a substantial number of cases. The relevant advent of biological treatment has changed but not eliminated the need for surgery in many patients. Despite previous publications on the indications for surgery in CD, there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications, surgical options, risk factors, and medications in pre- and perioperative period are reviewed in the light of available evidence. Risks and benefits of surgical options are addressed. An algorithm is proposed for the management of postsurgery monitoring, timing for follow-up endoscopy, and treatment options.

Published
2017

38. Complicated Disease and Response to Initial Therapy Predicts Early Surgery in Paediatric Crohn's Disease: Results From the Porto Group GROWTH Study.

Author

Levine A, Chanchlani N, Hussey S, Ziv-Baran T, Escher JC, Amil Dias J, Veres G, Koletzko S, Turner D, Kolho KL, Paerregaard A, Staiano A, Lionetti P, Nuti F, Sladek M, Shaoul R, Lazowska-Prezeorek I, Martin de Carpi J, Sigall Boneh R, Pfeffer Gik T, Cohen-Dolev N, and Russell RK

Subjects
Adolescent, Algorithms, Child, Cohort Studies, Crohn Disease diagnosis, Female, Humans, Male, Patient Selection, Predictive Value of Tests, Risk Factors, Severity of Illness Index, Treatment Outcome, Crohn Disease complications, Crohn Disease surgery
Abstract

Introduction: The ability to predict risk for poor outcomes in Crohn's disease [CD] would enable early treatment intensification. We aimed to identify children with CD with complications at baseline and throughout the study period who are at risk for surgery 2 years from diagnosis., Methods: Newly diagnosed children with CD were enrolled into a prospective, multicentre inception cohort. Disease characteristics and serological markers were obtained at baseline and week 12 thereafter. Outcome data including disease activity, therapies, complications and need for surgery were collected until the end of 104 weeks. A chi-square automatic interaction detection [CHAID] algorithm was used to develop a prediction model for early surgery., Results: Of 285 children enrolled, 31 [10.9%] required surgery within 2 years. Multivariate analysis identified stricturing disease at baseline (odds ratio [OR] 5.26, 95% confidence interval [CI] 2.02-13.67 [p = 0.001]), and Paediatric Crohn's Disease Activity Index [PCDAI] >10 at week 12 (OR 1.06, 95% CI 1.02-1.10 [p = 0.005]) as key predictors for early surgery. CHAID demonstrated that absence of strictures at diagnosis [7.6%], corticosteroid-free remission at week 12 [4.1%] and early immunomodulator therapy [0.8%] were associated with the lowest risk of surgery, while stricturing disease at diagnosis [27.1%, p < 0.001] or elevated PCDAI at week 12 [16.7%, p = 0.014] had an increased risk of surgery at follow-up. Anti-OmpC status further stratified high-risk patients., Discussion: A risk algorithm using clinical and serological variables at diagnosis and week 12 can categorize patients into high- and low-risk groups from diagnosis., (Copyright © 2019 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2020
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39. A Simple Endoscopic Score Modified for the Upper Gastrointestinal Tract in Crohn's Disease [UGI-SES-CD]: A Report From the ImageKids Study.

Author

Ledder O, Church P, Cytter-Kuint R, Martínez-León M, Sladek M, Coppenrath E, Weiss B, Yerushalmi B, Martin de Carpi J, Duchano L, Towbin A, Assa A, Shaoul R, Mearin ML, Alex G, Griffiths A, and Turner D

Subjects
Adolescent, Age Factors, Child, Child, Preschool, Female, Humans, Male, Predictive Value of Tests, Prospective Studies, Severity of Illness Index, Crohn Disease diagnosis, Crohn Disease therapy, Endoscopy, Digestive System
Abstract

Objective: There is no standardized endoscopic description of upper gastrointestinal [UGI] disease in Crohn's disease [CD]. We prospectively applied the Simple Endoscopic Score for CD [SES-CD] to the UGI tract as a planned sub-study of the multicentre prospective ImageKids study. We aimed to assess the utility of the UGI-SES-CD and its clinical significance in paediatric CD., Design: Patients underwent an oesophagogastroduodenoscopy [EGD], ileocolonoscopy, and magnetic resonance enterography [MRE] with explicit clinical data recorded. SES-CD was scored at each region [oesophagus, stomach body, antrum, and duodenum]. Half of the patients were followed for 18 months, when a repeat MRE was performed., Results: A total of 202 children were included 56% males, mean age 11.5 ± 3.2 years, median weighted Paediatric Crohn's Disease Activity Index [wPCDAI 25]). UGI-SES-CD score ranged 0-17, with 95 [47%] having a UGI-SES-CD ≥1; no narrowing was detected. UGI-SES-CD ≥1 was associated with higher: wPCDAI [32.5 vs 20; p = 0.03]; Physician's Global Assessment [PGA] of inflammation (45 mm visual analogue score [VAS] vs 30 mm VAS; p = 0.04); ileocolonoscopic SES-CD [10 vs 7; p = 0.004], faecal calprotectin [717 µg/g vs 654 µ/g; p= 0.046]; and radiological global assessment of damage by MRE [7 mm VAS vs 0; p = 0.04]. In all, 81 patients were followed for 18 months and no association was identified between initial UGI SES-CD and markers of disease course such as surgery, MRE assessment, or treatment escalation., Conclusion: UGI-SES-CD is an easily reported objective scoring system and is associated with a more severe disease phenotype but not with disease course., (Copyright © 2018 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2018
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40. Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn's Disease: Results From the GROWTH CD Study.

Author

Cohen-Dolev N, Sladek M, Hussey S, Turner D, Veres G, Koletzko S, Martin de Carpi J, Staiano A, Shaoul R, Lionetti P, Amil Dias J, Paerregaard A, Nuti F, Pfeffer Gik T, Ziv-Baran T, Ben Avraham Shulman S, Sarbagili Shabat C, Sigall Boneh R, Russell RK, and Levine A

Subjects
Abscess etiology, Adolescent, Biological Products therapeutic use, Child, Constriction, Pathologic etiology, Crohn Disease complications, Crohn Disease drug therapy, Female, Humans, Male, Propensity Score, Prospective Studies, Recurrence, Severity of Illness Index, Treatment Outcome, Adrenal Cortex Hormones therapeutic use, Body Height, Crohn Disease therapy, Enteral Nutrition, Rectal Fistula etiology, Remission Induction
Abstract

Background: Exclusive enteral nutrition [EEN] and corticosteroids [CS] induce similar rates of remission in mild to moderate paediatric Crohn's disease [CD], but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long-term outcomes., Methods: We prospectively followed newly diagnosed children aged < 17 years, with mild to moderate CD at baseline, for 2 years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks. Remission, relapses, complications [fibrostenotic disease, penetrating disease, and active perianal disease] and growth were recorded throughout the study. A propensity score analysis was performed., Results: A total of 147 children [mean age 12.9 ± 3.2 years], treated by EEN [n = 60] or CS [n = 87] were included. New complications developed in 13.7% of CS [12/87] versus 11.6% of EEN [7/60], p = 0.29. Remission was achieved in 41/87 [47%] in CS and 38/60 [63%] EEN, p = 0.036. Median time to relapse did not differ [14.4 ± 1 months with CS, 16.05 ± 1.1 EEN, p = 0.28]. Mean height Z scores decreased from Week 0 to Week 78 with CS [-0.34 ± 1.1 to -0.51 ± 1.2, p = 0.01], but not with EEN [-0.32 ± 1.1 to -0.22 ± 0.9, p = 0.56]. In a propensity score analysis, EEN was superior to CS for inducing remission [p = 0.05] and trended to superiority for height Z score [p = 0.055]., Conclusions: Use of EEN was associated with higher remission rates and a trend toward better growth but with similar relapse and complication rates in new-onset mild to moderate paediatric CD., (Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com)

Published
2018
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41. [A real-world study focused on the effectiveness and safety of adalimumab as first-line anti-TNF treatment for pediatric Crohn's disease].

Author

Navas-López VM, Pujol Muncunill G, Llerena E, Navalón Rubio M, Gil-Ortega D, Varea-Calderón V, Sierra Salinas C, and Martin-de-Carpi J

Subjects
Adalimumab adverse effects, Adolescent, Anti-Inflammatory Agents adverse effects, Child, Female, Humans, Male, Remission Induction, Retrospective Studies, Treatment Outcome, Adalimumab therapeutic use, Anti-Inflammatory Agents therapeutic use, Crohn Disease drug therapy, Tumor Necrosis Factor-alpha antagonists & inhibitors
Abstract

Background and Objectives: Adalimumab (ADA), a monoclonal humanised anti-TNF antibody, is usually prescribed as a second-line treatment in paediatric Crohn's disease (CD) patients who have become unresponsive or developed intolerance to infliximab (IFX). In the case series reported, more than 70% of patients had initially been treated with IFX. Data on short- and long-term effectiveness of ADA in anti-TNF naïve patients is limited. The aim of this study is to describe our experience with ADA as a first-line anti-TNF in paediatric CD patients., Material and Methods: This is a multicentre retrospective study including anti-TNF naïve paediatric CD patients treated with ADA as first-line anti-TNF., Results: Sixty-two patients (34males), with a mean age of 13.0±2.4years and a disease duration of 7.3 (IQR 2.7-21) months were included. Median wPCDAI was 35 (IQR 24.3-47.5). Fifty-eight out of 62 (93.5%) were on combo therapy at baseline. Clinical remission at week12 was achieved in 50 out of 62 (80.6%) and in 57 out of 60 (95.0%) at week52. Eight patients (13%) reported adverse events. Mean height, growth rate and BMI z-scores improved significantly between baseline and week 52, especially in patients with growth failure., Conclusions: ADA treatment leads to lasting clinical remission in anti-TNF naïve paediatric patients with CD. ADA significantly improved growth rate in children with CD who had growth delay at baseline., (Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2018
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