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How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study
BACKGROUND: In Korea, infliximab was approved for use in children with ulcerative colitis (UC) in October 2012. AIM: To compare the clinical course of UC before and after the introduction of biological agents, and to compare with the IBSEN study. METHODS: Patients under 18 years of age, who were dia...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372802/ https://www.ncbi.nlm.nih.gov/pubmed/36161040 http://dx.doi.org/10.3748/wjg.v28.i28.3666 |
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author | Kwon, Yiyoung Kim, Eun Sil Choe, Yon Ho Kim, Mi Jin |
author_facet | Kwon, Yiyoung Kim, Eun Sil Choe, Yon Ho Kim, Mi Jin |
author_sort | Kwon, Yiyoung |
collection | PubMed |
description | BACKGROUND: In Korea, infliximab was approved for use in children with ulcerative colitis (UC) in October 2012. AIM: To compare the clinical course of UC before and after the introduction of biological agents, and to compare with the IBSEN study. METHODS: Patients under 18 years of age, who were diagnosed with UC and followed from January 2003 to October 2020, were included in the study. Group A (n = 48) was followed for at least 2 years between January 2003 and October 2012, and Group B (n = 62) was followed for at least 2 years between November 2012 and October 2020. We compared endoscopic remission, drug composition, relapse rate, steroid-free period, and the quality of life of each group. We plotted the clinical course of the included patients using the pediatric UC activity index score, and compared our patients with those in the IBSEN study. RESULTS: After 2 years of treatment, colonoscopy evaluation revealed different outcomes in the two treatment groups. Remission was confirmed in 14 patients (29.2%) of Group A, and in 31 patients (50.0%) of Group B (P < 0.012). The median cumulative corticosteroid-free period was 3.0 years in Group A and 4.4 years in Group B. Steroid-free period of Group B was significantly longer than that of Group A (P < 0.001). There was a statistically significant difference between the two groups in evaluation of the relapse rate during the observation period (P < 0.001). The plotted clinical course graphs of Group A showed similar proportions to the graphs in the IBSEN study. However, in Group B, the proportion of patients corresponding to curve 1 (remission or mild severity after initial high activity) was high at 76% (47/62). CONCLUSION: The incidence of relapse has decreased and the steroid-free period has increased after the introduction of the biological agent. The clinical course also showed a different pattern from that of IBSEN study. The active use of biological agents may change the long-term disease course in moderate to severe pediatric UC. |
format | Online Article Text |
id | pubmed-9372802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-93728022022-09-23 How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study Kwon, Yiyoung Kim, Eun Sil Choe, Yon Ho Kim, Mi Jin World J Gastroenterol Retrospective Study BACKGROUND: In Korea, infliximab was approved for use in children with ulcerative colitis (UC) in October 2012. AIM: To compare the clinical course of UC before and after the introduction of biological agents, and to compare with the IBSEN study. METHODS: Patients under 18 years of age, who were diagnosed with UC and followed from January 2003 to October 2020, were included in the study. Group A (n = 48) was followed for at least 2 years between January 2003 and October 2012, and Group B (n = 62) was followed for at least 2 years between November 2012 and October 2020. We compared endoscopic remission, drug composition, relapse rate, steroid-free period, and the quality of life of each group. We plotted the clinical course of the included patients using the pediatric UC activity index score, and compared our patients with those in the IBSEN study. RESULTS: After 2 years of treatment, colonoscopy evaluation revealed different outcomes in the two treatment groups. Remission was confirmed in 14 patients (29.2%) of Group A, and in 31 patients (50.0%) of Group B (P < 0.012). The median cumulative corticosteroid-free period was 3.0 years in Group A and 4.4 years in Group B. Steroid-free period of Group B was significantly longer than that of Group A (P < 0.001). There was a statistically significant difference between the two groups in evaluation of the relapse rate during the observation period (P < 0.001). The plotted clinical course graphs of Group A showed similar proportions to the graphs in the IBSEN study. However, in Group B, the proportion of patients corresponding to curve 1 (remission or mild severity after initial high activity) was high at 76% (47/62). CONCLUSION: The incidence of relapse has decreased and the steroid-free period has increased after the introduction of the biological agent. The clinical course also showed a different pattern from that of IBSEN study. The active use of biological agents may change the long-term disease course in moderate to severe pediatric UC. Baishideng Publishing Group Inc 2022-07-28 2022-07-28 /pmc/articles/PMC9372802/ /pubmed/36161040 http://dx.doi.org/10.3748/wjg.v28.i28.3666 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Kwon, Yiyoung Kim, Eun Sil Choe, Yon Ho Kim, Mi Jin How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title | How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title_full | How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title_fullStr | How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title_full_unstemmed | How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title_short | How has the disease course of pediatric ulcerative colitis changed throughout the biologics era? A comparison with the IBSEN study |
title_sort | how has the disease course of pediatric ulcerative colitis changed throughout the biologics era? a comparison with the ibsen study |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372802/ https://www.ncbi.nlm.nih.gov/pubmed/36161040 http://dx.doi.org/10.3748/wjg.v28.i28.3666 |
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