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Paediatric Crohn's

Salvatore Cucchiara, Sara Isoldi, Valerio Nobili
No abstract text is available yet for this article.
January 17, 2019: Digestive and Liver Disease
Tarah Rigterink, Laura Appleton, Andrew S Day
BACKGROUND: Vitamin D deficiency is highly prevalent in children with inflammatory bowel disease (IBD). This may contribute to an increased risk of poor bone health and may also influence the course of disease. An optimal treatment strategy of vitamin D therapy in children with IBD has not yet been established. AIM: To analyse the published intervention studies of vitamin D therapy in children with IBD. METHODS: A systematic review was conducted of clinical studies involving children with IBD (including Crohn disease or ulcerative colitis) who had received vitamin D therapy...
January 22, 2019: World Journal of Clinical Pediatrics
Viktor Wintzell, Henrik Svanström, Ola Olén, Mads Melbye, Jonas F Ludvigsson, Björn Pasternak
BACKGROUND: Studies have shown an association between use of azathioprine and increased risk of acute pancreatitis in adult inflammatory bowel disease. However, whether an association exists among paediatric patients is not known. We aimed to investigate whether use of azathioprine is associated with the risk of acute pancreatitis in children with inflammatory bowel disease. METHODS: We did a nationwide register-based cohort study in Sweden (2006-16) and Denmark (2000-16)...
January 23, 2019: Lancet Child & Adolescent Health
Jiri Bronsky, Lissy de Ridder, Frank M Ruemmele, Anne Griffiths, Stephan Buderus, Ondrej Hradsky, Almuthe Christina Hauer
OBJECTIVES: Despite existence of international guidelines for diagnosis and management of inflammatory bowel diseases (IBD) in children, there might be differences in the clinical approach. METHODS: A survey on clinical practice in paediatric IBD was performed among members of the ESPGHAN Porto IBD working group and interest group, PIBD-NET, and IBD networks in Canada and German speaking countries (CIDsCANN, GPGE), using a web-based questionnaire. Responses to 63 questions from 106 paediatric IBD centres were collected...
January 17, 2019: Journal of Pediatric Gastroenterology and Nutrition
María Chaparro, Ana Garre, Elena Ricart, Eva Iglesias-Flores, Carlos Taxonera, Eugeni Domènech, Javier P Gisbert
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...
January 13, 2019: Alimentary Pharmacology & Therapeutics
Karen van Hoeve, Erwin Dreesen, Ilse Hoffman, Gert Van Assche, Marc Ferrante, Ann Gils, Séverine Vermeire
OBJECTIVES: Therapeutic drug monitoring has been proposed as a useful tool in the management of infliximab (IFX) treated patients with inflammatory bowel disease (IBD). The aim of this retrospective study was to determine whether IFX trough levels after induction therapy are predictive for outcome at week 52. METHODS: All paediatric IBD patients receiving maintenance IFX at our centre, with IFX trough level available at their first maintenance infusion and a follow-up of at least 52 weeks were included...
January 8, 2019: Journal of Pediatric Gastroenterology and Nutrition
James J Ashton, Florina Borca, Enrico Mossotto, Tracy Coelho, Akshay Batra, Nadeem A Afzal, Hang T T Phan, Michael Stanton, Sarah Ennis, Robert Mark Beattie
BACKGROUND: Anti-tumour necrosis factor-α (anti-TNF) therapy use has risen in paediatric-onset inflammatory bowel disease (PIBD). Whether this has translated into preventing/delaying childhood surgery is uncertain. The Wessex PIBD cohort was analysed for trends in anti-TNF-therapy and surgery. DESIGN: All patients diagnosed with PIBD within Wessex from 1997 to 2017 were assessed. The prevalence of anti-TNF-therapy and yearly surgery rates (resection and perianal) during childhood (<18 years) were analysed (Pearson's correlation, multivariate regression, Fisher's exact)...
January 9, 2019: Alimentary Pharmacology & Therapeutics
Christina Ong, Poh Ting Lim, Veena Logarajah, Maria Janelle Liwanag, Bi Xia Ang, Yuqin Cher, Fang Kuan Chiou, Ajmal Kader
BACKGROUND: Exclusive enteral nutrition (EEN) is as effective as corticosteroids in inducing remission in children with Crohn's disease (CD). However, over 50% of these children relapse by 12 months of diagnosis. Thiopurines are commonly prescribed as maintenance therapy for CD, but evidence for its efficacy is controversial. Data on the effectiveness of EEN in Southeast Asian (SEA) children with CD is scarce. This study aims to evaluate the efficacy of EEN induction therapy in a cohort of SEA children with newly diagnosed CD...
December 12, 2018: BMC Gastroenterology
Mallory Chavannes, Christine Martinez-Vinson, Lara Hart, Nicole Kaniki, Che-Yung Chao, Sally Lawrence, Kevan Jacobson, Jean-Pierre Hugot, Jérome Viala, Colette Deslandres, Prevost Jantchou, Ernest G Seidman
Background: Ustekinumab (UST) is effective in the treatment of adults with moderate to severe Crohn's disease (CD). There is a paucity of data on its use in children. Aim: To evaluate the response to UST in children with moderate to severe CD. Methods: This multi-centre retrospective cohort study identified children under 18 years old with CD who received open-labelled subcutaneous UST. The primary outcome was changes in mean abbreviated PCDAI (aPCDAI) between baseline and 3 and 12 months, and rate of clinical remission at 3 and 12 months...
December 12, 2018: Journal of Crohn's & Colitis
Jeffrey S Hyams, Marla Dubinsky, Joel Rosh, Frank M Ruemmele, Samantha F Eichner, Jen-Fue Maa, Andreas Lazar, Gabriela Alperovich, Nael M Mostafa, Anne M Robinson
BACKGROUND: In the IMAgINE 1 study, adalimumab induced and maintained remission of moderate-to-severe Crohn's disease in children. AIM: To assess the efficacy, pharmacokinetics, immunogenicity and safety of immunomodulator and adalimumab combination therapy vs adalimumab monotherapy in paediatric patients with Crohn's disease. METHODS: Patients 6-17 years old with moderate-to-severe Crohn's disease (n = 192) received weight-based adalimumab induction at baseline and week 2...
December 2, 2018: Alimentary Pharmacology & Therapeutics
Liselotte C de Kloet, Sebastian E E Schagen, Anemone van den Berg, Agnes Clement-de Boers, Mieke E C A M Houdijk, Daniëlle C M van der Kaay
BACKGROUND: Growth failure can be a unique manifestation of untreated intestinal inflammation in children with inflammatory bowel disease (IBD). It can, however, be difficult to diagnose IBD in the absence of symptoms or in the presence of aspecific gastrointestinal symptoms. A delay in diagnosis is a risk factor for lower adult height. CASE DESCRIPTION: A 15--year-old boy was referred to a paediatric endocrinologist for growth failure and delayed puberty. Additional investigations were performed and he was diagnosed with Crohn's disease...
November 19, 2018: Nederlands Tijdschrift Voor Geneeskunde
Adel Alghamdi, Konstantinos Gerasimidis, Gavin Blackburn, Didem Akinci, Christine Edwards, Richard K Russell, David G Watson
Metabolomic profiling using high resolution mass spectrometry with hydrophilic interaction chromatography was applied to 11 faecal extracts from eleven healthy children and to 43 faecal extracts from eleven children undergoing exclusive enteral nutrition for the treatment of active Crohn's disease (CD) at timepoints before, during (15, 30, and 60 days), and after treatment. Differences between the control and CD samples were identified at each timepoint. An orthogonal partial least square-discriminant analysis (OPLS-DA) model identified eight metabolites that were normally distributed according to Q-Q plots...
November 22, 2018: Metabolites
Ben Kang, So Yoon Choi, Young Ok Choi, Soo-Youn Lee, Sun-Young Baek, Insuk Sohn, Byung-Ho Choe, Hae Jeong Lee, Yon Ho Choe
Background and Aims: Mucosal healing is an important treatment goal in Crohn's disease. We investigated the association between serum infliximab trough levels and mucosal healing, and the infliximab cut-off levels required for mucosal healing in paediatric patients. Methods: In this multicentre, retrospective, cross-sectional study, medical records and electronic data of paediatric patients with luminal Crohn's disease, who had received infliximab for ≥1 year, were examined...
November 19, 2018: Journal of Crohn's & Colitis
Tomer Ziv-Baran, Séamus Hussey, Malgorzata Sladek, Jorge Amil Dias, Javier Martin de Carpi, Erasmo Miele, Gabor Veres, Paolo Lionetti, Sibylle Koletzko, Federica Nuti, Anders Paerregaard, Kaija-Leena Kolho, Richard K Russell, Ron Shaoul, Dror Weiner, Rotem Sigall Boneh, Johanna Escher, Lenne Finnby, Dan Turner, Arie Levine
BACKGROUND: Paediatric Crohn's disease is characteried by frequently relapsing disease which may lead to hospitalisations and complications. AIM: To develop predictive models for early relapse following first remission. METHODS: The GROWTH CD prospective inception cohort was designed to predict risk for early disease relapse and poor outcomes. Newly diagnosed children underwent endoscopies and imaging. They were phenotyped and followed at scheduled visits through 78 weeks for relapses...
November 18, 2018: Alimentary Pharmacology & Therapeutics
Andrea Brusaferro, Elena Cavalli, Edoardo Farinelli, Rita Cozzali, Nicola Principi, Susanna Esposito
OBJECTIVES: The main objective of this manuscript is to discuss our present knowledge of the relationships between dysbiosis and paediatric Crohn's disease (CD). The therapeutic role of the methods currently used to re-establish normal gut microbiota composition is also analysed. METHODS: PubMed was used to search for all of the studies published from January 2008 to June 2018 using the key words: "Crohn's disease" and "gut dysbiosis" or "microbiota" or "microbioma" or "probiotic" and "children" or "paediatric"...
October 15, 2018: Journal of Infection
Haiming Fang, Lian Fu, Jiajia Wang
Background: Fecal microbiota transplantation (FMT) is an emerging treatment approach for inflammatory bowel disease (IBD). The donor selection, the separation of fecal bacteria, the frequency of FMT, the way of infusion, the long-term safety, and efficacy are still uncertain. Aim: To further study the efficacy and safety and protocol of FMT for IBD. Methods: A systematic review and meta-analysis were conducted until February, 2018. Clinical remission was established as the primary outcome...
2018: BioMed Research International
Zaina T Al-Salama
PF-06438179/GP1111 (Zessly® ; Ixifi® ) [hereafter referred to as GP1111] is a biosimilar of the reference monoclonal anti-TNF-α antibody infliximab, and is approved in the EU and USA for the same indications as the reference drug, including rheumatoid arthritis (RA), Crohn's disease, ulcerative colitis (including paediatric ulcerative colitis in the EU), ankylosing spondylitis, psoriatic arthritis and plaque psoriasis; GP1111 is also approved in Japan. GP1111 has similar physicochemical characteristics and pharmacodynamic properties to those of reference infliximab, and the pharmacokinetic similarity of the agents has been shown in healthy volunteers and patients with moderate-to-severe RA despite methotrexate therapy...
October 4, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Karen van Hoeve, Erwin Dreesen, Ilse Hoffman, Gert Van Assche, Marc Ferrante, Ann Gils, Séverine Vermeire
Background: The role of therapeutic drug monitoring for infliximab [IFX] therapy in children with inflammatory bowel disease [IBD] is poorly investigated. We determined if IFX exposure correlates with long-term remission in children. Methods: In this retrospective study, all children with Crohn's disease [CD] and ulcerative colitis [UC], receiving maintenance IFX at our centre, were included. Serum trough levels and cumulative drug exposure were correlated with clinical, biological, and endoscopic remission...
November 15, 2018: Journal of Crohn's & Colitis
Giovanni Di Nardo, Carlo Calabrese, Roberto Conti Nibali, Arianna De Matteis, Emanuele Casciani, Luigi Martemucci, Giuseppe Pagliaro, Nico Pagano
Introduction: Device-assisted enteroscopy is a new endoscopic technique for the evaluation of small bowel in adults and children. Data in pediatric population are limited. This review aims to identify diagnostic and therapeutic benefits of enteroscopy in children. Methods: We have analysed paediatric literature on device-assisted enteroscopy focusing on indications, technical aspects and complications, with attention given to adult publications that may be applicable to the paediatric population...
August 2018: United European Gastroenterology Journal
Catherine L Wall, Richard B Gearry, Andrew S Day
Background and Aim: Enteral nutrition (EN) is not commonly used for the treatment of adults with active Crohn's disease (CD), despite patient interest in nutrition-based alternatives to corticosteroids and evidence of efficacy in paediatric CD. The aim of this study was to assess the impact of 2 different EN regimens on disease symptoms, nutrition and inflammatory markers in young adults with active CD. Methods: A prospective non-randomized pilot study of adults aged 16-40 years with active CD on endoscopy or imaging was undertaken...
July 2018: Inflammatory Intestinal Diseases
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