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Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review

BACKGROUND AND OBJECTIVE: The landscape of paediatric inflammatory bowel disease (pIBD) continues to evolve in an era of increasing incidence. There have been rapid developments in understanding, as we begin to perceive IBD as a spectrum of conditions, alongside advancements in monitoring and treatm...

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Autores principales: Green, Zachary, Beattie, Robert Mark, Ashton, James J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644027/
https://www.ncbi.nlm.nih.gov/pubmed/37969128
http://dx.doi.org/10.21037/tp-23-210
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author Green, Zachary
Beattie, Robert Mark
Ashton, James J.
author_facet Green, Zachary
Beattie, Robert Mark
Ashton, James J.
author_sort Green, Zachary
collection PubMed
description BACKGROUND AND OBJECTIVE: The landscape of paediatric inflammatory bowel disease (pIBD) continues to evolve in an era of increasing incidence. There have been rapid developments in understanding, as we begin to perceive IBD as a spectrum of conditions, alongside advancements in monitoring and treatment. The objective of this article was to provide an overview of recent advances and challenges in the management of pIBD, with a focus on sustainable healthcare, personalised therapy, genomics, new drugs and avenues for future optimisation. METHODS: We present a narrative review that synthesises and summarises recent research (2017–2022) related to pIBD. We undertook a structured search of the literature (PubMed and Medline) and additional articles were identified through manual searches of reference lists. Evidence tables were compiled for disease outcomes. KEY CONTENT AND FINDINGS: In this review we outline current practice, integrating clinical guidelines and contemporary research. We discuss initial investigations (including suggested threshold for paediatric faecal calprotectin), specialist investigations for disease monitoring [with reference to video capsule endoscopy (VCE) and therapeutic drug levels] and outline new and established treatment options. Biomarkers and genomic testing are examined as important tools for individualising care and identifying potential therapeutic targets, including for top-down therapy. Despite these advances, significant challenges remain, including the need for further research to understand the mechanisms of disease and the translation of these advances into real-world improvements in practice. CONCLUSIONS: Recent advances in understanding of the pathogenesis of pIBD, alongside genomic and pharmacological developments have added more tools to the armamentarium for the treatment of these conditions and highlighted ongoing areas of research need.
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spelling pubmed-106440272023-11-15 Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review Green, Zachary Beattie, Robert Mark Ashton, James J. Transl Pediatr Review Article BACKGROUND AND OBJECTIVE: The landscape of paediatric inflammatory bowel disease (pIBD) continues to evolve in an era of increasing incidence. There have been rapid developments in understanding, as we begin to perceive IBD as a spectrum of conditions, alongside advancements in monitoring and treatment. The objective of this article was to provide an overview of recent advances and challenges in the management of pIBD, with a focus on sustainable healthcare, personalised therapy, genomics, new drugs and avenues for future optimisation. METHODS: We present a narrative review that synthesises and summarises recent research (2017–2022) related to pIBD. We undertook a structured search of the literature (PubMed and Medline) and additional articles were identified through manual searches of reference lists. Evidence tables were compiled for disease outcomes. KEY CONTENT AND FINDINGS: In this review we outline current practice, integrating clinical guidelines and contemporary research. We discuss initial investigations (including suggested threshold for paediatric faecal calprotectin), specialist investigations for disease monitoring [with reference to video capsule endoscopy (VCE) and therapeutic drug levels] and outline new and established treatment options. Biomarkers and genomic testing are examined as important tools for individualising care and identifying potential therapeutic targets, including for top-down therapy. Despite these advances, significant challenges remain, including the need for further research to understand the mechanisms of disease and the translation of these advances into real-world improvements in practice. CONCLUSIONS: Recent advances in understanding of the pathogenesis of pIBD, alongside genomic and pharmacological developments have added more tools to the armamentarium for the treatment of these conditions and highlighted ongoing areas of research need. AME Publishing Company 2023-10-27 2023-10-30 /pmc/articles/PMC10644027/ /pubmed/37969128 http://dx.doi.org/10.21037/tp-23-210 Text en 2023 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article
Green, Zachary
Beattie, Robert Mark
Ashton, James J.
Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title_full Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title_fullStr Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title_full_unstemmed Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title_short Recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
title_sort recent developments in the assessment and management of inflammatory bowel disease in childhood: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644027/
https://www.ncbi.nlm.nih.gov/pubmed/37969128
http://dx.doi.org/10.21037/tp-23-210
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