Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU. Issue 4 (13th January 2019)

• Record Type: Journal Article
• Authors: Chaparro, María; Garre, Ana; Ricart, Elena; Iglesias‐Flores, Eva; Taxonera, Carlos; Domènech, Eugeni; Gisbert, Javier P.
• Other Names: Mañosa Miriam investigator.; Vera Mendoza Isabel investigator.; Mínguez Miguel investigator.; Argüelles Federico investigator.; de Castro Parga Luisa investigator.; Arroyo Maite investigator.; López‐Sanromán Antonio investigator.; Rivero Tirado Montserrat investigator.; Guardiola Jordi investigator.; Martín Arranz María Dolores investigator.; Beltrán Belén investigator.; Barrio Jesús investigator.; Riestra Sabino investigator.; García‐Planella Esther investigator.; Calvet Xavier investigator.; Alcaín Guillermo investigator.; Sicilia Beatriz investigator.; García Santiago investigator.; Esteve Maria investigator.; Márquez Lucía investigator.; Fernández Salazar Luis Ignacio investigator.; Casbas Ana Gutiérrez investigator.; Piqueras Marta investigator.; Bermejo Fernando investigator.; Pérez Calle José Lázaro investigator.; Hinojosa Joaquín investigator.; Rodríguez Pérez Antonio investigator.; Aldeguer Xavier investigator.; García Sepulcre Mariana Fe investigator.; Bujanda Luis investigator.; Martínez Montiel Pilar investigator.; Lorente Poyatos Rufo investigator.; Rodríguez Gutiérrez Cristina investigator.; Merino Olga investigator.; Cabriada José Luis investigator.; Roncero Óscar investigator.; Romero Cara Patricia investigator.; Navarro‐Llavat Mercè investigator.; Ber Yolanda investigator.; Madrigal Rosa Eva investigator.; Van Domselaar Manuel investigator.; Barreiro‐de Acosta Manuel investigator.; Llaó Jordina investigator.; Ramos Laura investigator.; Riera Joan investigator.; Lucendo Villarín Alfredo J investigator.; Rodríguez González Esther investigator.; Huguet Malavés José M investigator.; Muñoz Villafranca Carmen investigator.; Almela Pedro investigator.; Charro Mara investigator.; Ramírez de la Piscina Patricia investigator.; Sesé Eva investigator.; Lacruz Águeda Abad investigator.; Khorrami Sam investigator.; Morales Alvarado Víctor Jair investigator.; Legido Gil Jesús investigator.; Trapero Martínez Ana Mª investigator.; Pajares Villaroya Ramón investigator.; Acevedo Juan investigator.; García Herola Antonio investigator.; Hernández Villalba Luís investigator.; Muñoz Esther investigator.; Novella Durán María Teresa investigator.; Menacho Margarita investigator.; Navas López Víctor Manuel investigator.; Dolores Retamero María investigator.; Bernardo David investigator.; Muriel Alfonso investigator.;
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 49:Issue 4(2019)
• Page Start: 419
• Page End: 428
• Publication Date: 2019-01-13
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.15114
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Cohort studies comparing the characteristics of childhood‐onset and adulthood‐onset inflammatory bowel disease (IBD) in the biologics era are scarce. Aim: To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood‐ and adulthood‐onset IBD. Methods: Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood‐onset cohort comprised patients diagnosed at ≤16 years of age and the adulthood‐onset cohort those diagnosed at >16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan‐Meier curves, compared by the log‐rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. Results: The adulthood‐onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood‐onset cohort 846 (4%). Median follow‐up was 54 months in the childhood‐onset cohort and 38 months in the adulthood‐onset cohort ( P < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood‐onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood‐onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1‐1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1‐1.3). However, childhood‐onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8‐1.2). Conclusions: Childhood‐onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood‐onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery.