Diagnostic and Therapeutic Approach in Paediatric Inflammatory Bowel Diseases: Results from a Clinical Practice Survey
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Biosimilar Pharmaceuticals therapeutic use MeSH
- Digestive System Surgical Procedures methods standards statistics & numerical data MeSH
- Crohn Disease diagnosis therapy MeSH
- Child MeSH
- Guideline Adherence statistics & numerical data MeSH
- Gastroenterology methods standards statistics & numerical data MeSH
- Gastrointestinal Agents therapeutic use MeSH
- Inflammatory Bowel Diseases diagnosis therapy MeSH
- Immunologic Factors therapeutic use MeSH
- Infliximab therapeutic use MeSH
- Practice Patterns, Physicians' statistics & numerical data MeSH
- Humans MeSH
- Adolescent MeSH
- Pediatrics methods standards statistics & numerical data MeSH
- Health Care Surveys MeSH
- Practice Guidelines as Topic MeSH
- Colitis, Ulcerative diagnosis therapy MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Canada MeSH
- Germany MeSH
- Names of Substances
- Biosimilar Pharmaceuticals MeSH
- Gastrointestinal Agents MeSH
- Immunologic Factors MeSH
- Infliximab MeSH
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. RESULTS: Eighty-four percentage of centres reported to fulfil the revised Porto criteria in the majority of patients. In luminal Crohn disease (CD), exclusive enteral nutrition is used as a first-line induction therapy and immunomodulators (IMM) are used since diagnosis in the majority of patients. Infliximab (IFX) is mostly considered as first-line biological. Sixty percentage of centres have experience with vedolizumab and/or ustekinumab and 40% use biosimilars. In the majority of ulcerative colitis (UC) patients 5-aminosalicylates are continued as concomitant therapy to IMM (usually azathioprine [AZA]/6-MP). After ileocaecal resection (ICR) in CD patients without postoperative residual disease, AZA monotherapy is the preferred treatment. CONCLUSIONS: A majority of centres follows both the Porto diagnostic criteria as well as paediatric (ESPGHAN/ECCO) guidelines on medical and surgical IBD management. This reflects the value of international societal guidelines. However, potentially desirable answers might have been given instead of what is true daily practice, and the most highly motivated people might have answered, leading to some bias.
Department of Paediatrics Hospital for Sick Children University of Toronto Toronto Ontario Canada
References provided by Crossref.org
Prediction of thiopurine failure in pediatric Crohn's disease: pediatric IBD Porto group of ESPGHAN
