The need for surgery in pediatric patients with inflammatory bowel disease treated with biologicals

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Abstract

Purpose: Inflammatory bowel disease (IBD) in childhood often presents with a more extensive and more aggressive disease course than adult-onset disease. We aimed to evaluate if biological treatment started in childhood decreases the need for intestinal surgery over time. Methods: This was a retrospective, single-center, cohort study. All pediatric patients with IBD initiated to biological therapy at the Children’s Hospital, were included in the study and followed up to the first surgical procedure or re-operation in their adulthood or until 31.12.2021 when ≥ 18 of age. Data were collected from the pediatric registry of IBD patients with biologicals and medical charts. Results: A total of 207 pediatric IBD patients were identified [150 with Crohn´s disease (CD), 31 with ulcerative colitis (UC), 26 with IBD unclassified (IBDU)] of which 32.9% (n = 68; CD 49, UC 13, IBDU 6) underwent intestinal surgery. At the end of a median follow-up of 9.0 years (range 2.0-25.9), patients reached a median age of 21.4 years (range 18–36). Patients who had intestinal surgery in childhood were more likely to have IBD-related surgery also in early adulthood. The duration of the disease at induction of the first biological treatment emerged as the only risk factor, with a longer duration in the surgical group than in patients with no surgery. Conclusion: Despite initiation of biological treatment, the risk of intestinal surgery remains high in pediatric IBD patients and often the need for surgery emerges after the transition to adult IBD clinics.

Original languageEnglish
Article number58
JournalInternational Journal of Colorectal Disease
Volume39
Issue number1
Number of pages10
ISSN0179-1958
DOIs
Publication statusPublished - Dec 2024
MoE publication typeA1 Journal article-refereed

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Fields of Science

  • Anti-TNFα
  • Children
  • Crohn´s disease
  • Infliximab
  • Ulcerative colitis
  • 3121 General medicine, internal medicine and other clinical medicine
  • 3126 Surgery, anesthesiology, intensive care, radiology

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