Minerva Pediatrics 2021 Apr 12

DOI: 10.23736/S2724-5276.21.06099-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Mucosal healing is not associated with better outcome during 7 years of follow-up in pediatric patients with Crohn’s disease

Jan MELEK ¹ ✉, Markéta ŠTANCLOVÁ ¹, Petr DĚDEK ¹, Radek ŠTICHHAUER ², Jaroslav KOUDELKA ², Tomáš DOUDA ³, Ilja TACHECÍ ³, Ladislav DOUDA ³, Tomáš VAŇÁSEK ⁴, Jan BUREŠ ³

¹ Department of Pediatrics, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic; ² Department of Pediatric Surgery and Traumatology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic; ³ 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic; ⁴ Hepato-Gastroenterologie HK, s.r.o, Hradec Králové, Czech Republic

BACKGROUND: Mucosal healing (MH) has become a perspective treatment target in patients with Crohn’s disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce.
METHODS: 76 pediatric patients with CD were evaluated retrospectively (2000-2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, n= 17; and No MH, n=59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD.
RESULTS: The number of hospitalized patients was 24% in the MH group and 42% in the No MH group, P = 0.26. The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P = 0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH, P>0.99. 24% patients in the MH group and 39% patients in the No MH group underwent CD-related operation, P = 0.39. Time to the first operation was 43 months for MH and 19 months for the No MH group, P = 0.13. The follow-up period was 91 months in the MH group and 80 months in the No MH group, P = 0.74. The use of infliximab was positively associated with MH, P = 0.002.
CONCLUSIONS: MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.

KEY WORDS: Hospitalization; Long-term outcome; Mucosal healing; Operation; Pediatric Crohn’s disease