Title :

Impact of extra-intestinal manifestations at diagnosis on disease outcome in pediatric- and elderly-onset crohn''s disease: a french population-based study

Author(s) :

Duricova, Dana [Auteur]
Sarter, Helene [Auteur]
Savoye, Guillaume [Auteur]
Leroyer, Ariane [Auteur]
IMPact de l'Environnement Chimique sur la Santé humaine (IMPECS) - EA 4483
IMPact de l'Environnement Chimique sur la Santé humaine (IMPECS) - EA 4483
Pariente, Benjamin [Auteur]
Armengol-Debeir, Laura [Auteur]
Bouguen, Guillaume [Auteur]
Ley, Delphine [Auteur]
Turck, Dominique [Auteur]
Templier, Carole [Auteur]
Buche, Sebastien [Auteur]
Peyrin-Biroulet, Laurent [Auteur]
Gower, Corinne [Auteur]
Fumery, Mathurin [Auteur]

Journal title :

Inflammatory Bowel Diseases

Abbreviated title :

Inflamm. Bowel Dis.

Publication date :

2018-08-01

ISSN :

1536-4844

Keyword(s) :

elderly
extra-intestinal manifestation
pediatric
Crohns disease

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Extraintestinal manifestations (EIM) have been associated with more severe course of inflammatory bowel disease. The aim was to study the frequency of EIM in pediatric- and elderly-onset Crohn's disease (CD) and the factors ...
Show more >Extraintestinal manifestations (EIM) have been associated with more severe course of inflammatory bowel disease. The aim was to study the frequency of EIM in pediatric- and elderly-onset Crohn's disease (CD) and the factors associated with EIM and their impact on long-term disease outcome. Pediatric- (age at diagnosis younger than 17 years) and elderly-onset CD patients (age at diagnosis 60 years or older) from a prospective population-based registry (EPIMAD) were recruited. Data on EIM and clinical factors at diagnosis and at maximal follow-up were collected. We included 535 pediatric- and 370 elderly-onset patients (median age 14.5 and 69.9 years; median follow-up 11.1 and 5.9 years). Extraintestinal manifestations presented in 23.5% of childhood-onset and 4.9% of elderly-onset individuals at diagnosis, while in 29.8% and 5.9% of patients, EIM developed newly during the follow-up (hazard ration [HR] 4.4, 95% CI, 2.7-7.0, P < 0.001). The most frequently involved organ in both age cohorts, either at diagnosis or during disease course, were joints (pediatric: 11.2% and 22.6%; elderly: 3.2% and 3.5%, respectively) followed by skin (pediatric: 15.9% and 13.6%; elderly: 2.7% and 2.7%, respectively). Extraintestinal manifestations at diagnosis were associated with increased risk for corticosteroids (HR 1.42, 95% CI, 1.14-1.78 and HR 3.38, 95% CI, 1.88-6.08) and immunosuppressive therapy (HR 1.30, 95% CI, 1.02-1.65 and HR 4.24, 95% CI, 1.91-9.42), in both age populations. Extraintestinal manifestations occurred at lower frequency in elderly-onset compared with pediatric-onset patients. In both age populations, presence of EIM at diagnosis independently increased the need for corticosteroid and immunosuppressive treatment.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• IMPact de l'Environnement Chimique sur la Santé humaine (IMPECS) - ULR 4483
• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2022-02-02T10:23:55Z