Titre :

New therapeutic strategies have changed the natural history of paediatric Crohn's disease: a two-decade population-based study.

Auteur(s) :

Ley, Delphine [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Leroyer, Ariane [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Dupont, Claire [Auteur]
Université de Caen Normandie [UNICAEN]
Sarter, Helene [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Bertrand, V. [Auteur]
Spyckerelle, C. [Auteur]
Guillon, Nathalie [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Wils, Pauline [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Savoye, G. [Auteur]
Turck, Dominique [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Gower, Corinne [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Fumery, Mathurin [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Titre de la revue :

Clinical Gastroenterology and Hepatology

Nom court de la revue :

Clin Gastroenterol Hepatol

Numéro :

20

Pagination :

2588-2597

Date de publication :

2022-02-13

ISSN :

1542-7714

Mot(s)-clé(s) en anglais :

Inflammatory Bowel Disease
Crohn's Disease
Disease Course
Anti-TNF

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background & Aims We evaluated the impact of immunosuppressants (IS) and anti–tumor necrosis factor (TNF) introduction on Crohn’s disease (CD) long-term outcomes in a large population-based, pediatric-onset cohort. Methods All ...
Lire la suite >Background & Aims We evaluated the impact of immunosuppressants (IS) and anti–tumor necrosis factor (TNF) introduction on Crohn’s disease (CD) long-term outcomes in a large population-based, pediatric-onset cohort. Methods All patients included in the EPIMAD registry with a diagnosis of CD occurring when they were younger than age 17 years and between 1988 and 2011 were followed up retrospectively until 2013. Three diagnostic periods were defined: 1988 to 1993 (period [P]1; pre-IS era), 1994 to 2000 (P2; pre–anti-TNF era), and 2001 to 2011 (P3; anti-TNF era). Medication exposure and disease outcomes were compared between the 3 diagnostic periods. Results A total of 1007 patients diagnosed with CD were followed up for a median duration of 8.8 years (interquartile range, 4.6–14.2 y). The IS and anti-TNF exposure rate at 5 years increased over time from 33.9% (in P1) to 76.5% (in P3) and from 0% (in P1) to 50.5% (in P3), respectively. In parallel, the risk for intestinal resection at 5 years decreased significantly over time (P1, 35%; P2, 31%; and P3, 22%; P = .0003, Ptrend < .0001), and between the pre–anti-TNF era (P1 + P2, 32%) and the anti-TNF era (P3, 22%) (P = .0007). The risk for progression from inflammatory to stricturing behavior decreased significantly over time (P1, 27%; P2, 28%; and P3, 20%; P = .11, Ptrend = .041) and between the pre–anti-TNF era (P1 + P2, 28%) and the anti-TNF era (P3, 20%) (P = .040). The risk for a CD flare–related hospitalization at 5 years remained stable over time (P1, 31%; P2, 31%; and P3, 29%; P = .76, Ptrend = .53). Conclusions In parallel with the increased use of IS and anti-TNF, positive changes in the natural history of pediatric-onset CD were observed at the population level. A decreased risk of both intestinal resections and stricturing complications were observed during the anti-TNF era.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille
Institut Pasteur de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Date de dépôt :

2023-10-20T06:10:26Z
2024-02-28T14:51:25Z