Children with Crohn’s disease

Thursday, 24 November 2011 17:15

Research news

What is their outcome ?

Crohn’s disease (CD) affects young people  and in nearly 15% of cases its onset occurs in childhood (before 17 years of age). The EPIMAD study (the largest international study in a general population), describes evolution of the disease over the long term in persons diagnosed before the age of 17.

A total of 538 cases of CD were studied, including 293 boys and 245 girls with an average age of 14 at diagnosis; they were followed for a mean period of 11.5 years.  Evolution of CD was marked by stability at the digestive site in 74.6% of them, extension in 11.1% and disease regression in 14.3%, linked to healing of colic lesions.

Purely inflammatory forms of the disease decreased, while more complicated forms (stenoses and/or fistulas) increased between the period of diagnosis and the date of  most recent  information.  The probability of  having to use immunosuppressants and anti-TNFa at 1, 5, 10 and 20 years was, respectively, 21.6 and  2.4% at 1 year, 50.9 and 16.1% at 5 years, 65.7% and 29.3% at 10 years and  74% and 49.1% at 20 years. The probability of intestinal resection was 8.8% at 1 year, 14.7% at 2 years, 30.6% at 5 years, 43.6% at 10 years and 53.8% at 20 years.

The natural history of pediatric CD in the overall population is characterized by stable localization in 75% of cases, with evolution toward a complicated form in nearly 60% of cases.

After 20 years of evolution, ¾ of   young patients had received immunosuppressive treatment, nearly half had been given biotherapy (anti-TNFa) and more than 1 out of 2 had undergone intestinal resection.

References

Article submitted to the congress ECCO, DDW, and the "Journées Françaises de Pathologie Digestive"

Authors:

Anaïs Peneau, Julia Salleron, Mathurin Fumery, Guillaume Savoye, Eric Lerebours, Jean-Louis Dupas, Véronique Merle, Antoine Cortot, Olivier Mouterde, Claire Spyckerelle, Djamal Djeddi, Dominique Turck, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel, Corinne Gower-Rousseau.