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Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease-Ahead Program
E. Orlanski-Meyer, M. Aardoom, A. Ricciuto, D. Navon, N. Carman, M. Aloi, J. Bronsky, J. Däbritz, M. Dubinsky, S. Hussey, P. Lewindon, J. Martin De Carpi, VM. Navas-López, M. Orsi, FM. Ruemmele, RK. Russell, G. Veres, TD. Walters, DC. Wilson, T....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, metaanalýza, práce podpořená grantem, systematický přehled
- MeSH
- dítě MeSH
- hodnocení výsledků zdravotní péče MeSH
- kojenec MeSH
- kolektomie MeSH
- konsensus MeSH
- lidé MeSH
- mladiství MeSH
- novorozenec MeSH
- prediktivní hodnota testů MeSH
- předškolní dítě MeSH
- prognóza MeSH
- ulcerózní kolitida diagnóza terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
BACKGROUND & AIMS: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms. METHODS: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC. A systematic review of the literature, with selected meta-analysis, was performed to identify studies that investigated predictors for these outcomes. Multiple national and international meetings were held to reach consensus on evidence-based statements. RESULTS: Consensus was reached on 31 statements regarding predictors of colectomy, acute severe colitis (ASC), chronically active pediatric UC, cancer and mortality. At diagnosis, disease extent (6 studies, N = 627; P = .035), Pediatric Ulcerative Colitis Activity Index score (4 studies, n = 318; P < .001), hemoglobin, hematocrit, and albumin may predict colectomy. In addition, family history of UC (2 studies, n = 557; P = .0004), extraintestinal manifestations (4 studies, n = 526; P = .048), and disease extension over time may predict colectomy, whereas primary sclerosing cholangitis (PSC) may be protective. Acute severe colitis may be predicted by disease severity at onset and hypoalbuminemia. Higher Pediatric Ulcerative Colitis Activity Index score and C-reactive protein on days 3 and 5 of hospital admission predict failure of intravenous steroids. Risk factors for malignancy included concomitant diagnosis of primary sclerosing cholangitis, longstanding colitis (>10 years), male sex, and younger age at diagnosis. CONCLUSIONS: These evidence-based consensus statements offer predictions to be considered for a personalized medicine approach in treating pediatric UC.
Children's Hospital of Eastern Ontario IBD Centre University of Ottawa Ottawa Canada
Department of General Pediatrics University Hospital Münster Germany
Department of Pediatrics University Hospital Motol Prague Czech Republic
Division of Gastroenterology Hepatology and Nutrition the Hospital for Sick Children Toronto Canada
Erasmus Medical Center Sophia Children's Hospital Rotterdam the Netherlands
Institute IMAGINE Inserm U1163 Paris France
Pediatric Gastroenterology and Nutrition Mount Sinai Kravis Children's Hospital
Pediatric Gastroenterology and Nutrition Unit Hospital Regional Universitario de Málaga Spain
Pediatric Gastroenterology Unit Sapienza University of Rome Umberto 1 Hospital Rome Italy
Pediatric Institute Clinic University of Debrecen Hungary
Susan and Leonard Feinstein IBD Clinical Center Icahn School of Medicine Mount Sinai New York
Université Paris Descartes Sorbonne Paris Cité
University Medical Center Rostock Department of Pediatrics Rostock Germany
Citace poskytuje Crossref.org
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