Disease Activity Patterns of Paediatric Inflammatory Bowel Disease - A Danish Nationwide Cohort Study (1996-2018)

Mads Damsgaard Wewer*, Sabine Jansson, Mikkel Malham, Johan Burisch, Vibeke Wewer

*Corresponding author for this work

Abstract

BACKGROUND AND AIMS: Inflammatory bowel diseases [IBD] are heterogeneous in the frequency and severity of their flare-ups. We aimed to describe disease activity patterns in a Danish nationwide paediatric IBD cohort.

METHODS: Paediatric patients [<18 years at diagnosis] with Crohn's disease [pCD] or ulcerative colitis [pUC] in the study period from 1996 to 2018 were identified in national registers. Disease activity [severe, moderate-to-mild, remission] was assessed at diagnosis according to medications prescribed, hospitalizations, and surgeries.

RESULTS: In total, 1965 pCD and 1838 pUC incident patients were included in the cohort. At diagnosis, severe disease activity was found in 87%/80% of pCD/pUC and in addition 6.1% of pUC patients had undergone a colectomy during the first year after diagnosis. Five years after diagnosis, the annual proportions of pCD/pUC with no disease activity were 70%/61%, and 10 years after diagnosis the proportions were 72%/64%. Colectomy was required in 6.1, 12, and 16% of pUC patients after 1, 5 and 10 years. No improvement of disease activity was seen in the proportion of prevalent pCD [N = 2515] and pUC [N = 2428] in the study period 2000-2018 concomitant with the introduction of biological treatment. However, decreasing disease activity was the most common pattern in both pCD and pUC [43 and 47%], respectively.

CONCLUSIONS: pIBD was characterized by a high proportion of patients with severe activity at diagnosis, followed by an improvement after 5 and 10 years of follow-up. Notably, the proportion of patients with no disease activity was unchanged when biological treatment was introduced and the number of colectomies in pUC remained high.

Original languageEnglish
JournalJournal of Crohn's & colitis
Volume18
Issue number2
Pages (from-to)246-255
Number of pages10
ISSN1873-9946
DOIs
Publication statusPublished - 26 Feb 2024

Keywords

  • Child
  • Cohort Studies
  • Colitis, Ulcerative/diagnosis
  • Crohn Disease/diagnosis
  • Denmark/epidemiology
  • Humans
  • Inflammatory Bowel Diseases/diagnosis

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