Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU
Por:
Chaparro, M, Garre, A, Ricart, E, Iglesias-Flores, E, Taxonera, C, Domenech, E, Manosa, M, Mendoza, I, Minguez, M, Arguelles, F, Parga, L, Arroyo, M, Lopez-Sanroman, A, Tirado, M, Guardiola, J, Arranz, M, Beltran, B, Barrio, J, Riestra, S, Garcia-Planella, E, Calvet, X, Alcain, G, Sicilia, B, Garcia, S, Esteve, M, Marquez, L, Salazar, L, Casbas, A, Piqueras, M, Bermejo, F, Calle, J, Hinojosa, J, Perez, A, Aldeguer, X, Sepulcre, M, Bujanda, L, Montiel, P, Poyatos, R, Gutierrez, C, Merino, O, Cabriada, J, Roncero, O, Cara, P, Navarro-Llavat, M, Ber, Y, Madrigal, R, Van Domselaar, M, Barreiro-de Acosta, M, Llao, J, Ramos, L, Riera, J, Villarin, A, Gonzalez, E, Malaves, J, Villafranca, C, Almela, P, Charro, M, de la Piscina, P, Sese, E, Lacruz, A, Khorrami, S, Alvarado, V, Gil, J, Martinez, A, Villaroya, R, Acevedo, J, Herola, A, Villalba, L, Munoz, E, Duran, M, Menacho, M, Lopez, V, Retamero, M, Bernardo, D, Muriel, A, Gisbert, J and ENEIDA Study Grp
Publicada:
1 feb 2019
Resumen:
Background Cohort studies comparing the characteristics of childhood-onset and adulthood-onset inflammatory bowel disease (IBD) in the biologics era are scarce. Aim To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood- and adulthood-onset IBD. Methods Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood-onset cohort comprised patients diagnosed at <= 16 years of age and the adulthood-onset cohort those diagnosed at >16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan-Meier curves, compared by the log-rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. Results The adulthood-onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood-onset cohort 846 (4%). Median follow-up was 54 months in the childhood-onset cohort and 38 months in the adulthood-onset cohort (P < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood-onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood-onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1-1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1-1.3). However, childhood-onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8-1.2). Conclusions Childhood-onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood-onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery.
Filiaciones:
Chaparro, M:
Hosp Univ de La Princesa, Inst Invest Sanitaria Princesa IIS IP, Gastroenterol Unit, Madrid, Spain
Hosp Univ de La Princesa, CIBERehd, Madrid, Spain
Hosp Univ de La Princesa, Gastroenterol Unit, IIS IP, Madrid, Spain
CIBERehd, Madrid, Spain
Garre, A:
Hosp Univ de La Princesa, Inst Invest Sanitaria Princesa IIS IP, Gastroenterol Unit, Madrid, Spain
Hosp Univ de La Princesa, CIBERehd, Madrid, Spain
Hosp Univ de La Princesa, Gastroenterol Unit, IIS IP, Madrid, Spain
CIBERehd, Madrid, Spain
Ricart, E:
Hosp Clin Barcelona, Gastroenterol Unit, Barcelona, Spain
Hosp Clin Barcelona, CIBEREHD, Barcelona, Spain
CIBERehd, Barcelona, Spain
Iglesias-Flores, E:
Hosp Reina Sofia, Gastroenterol Unit, Cordoba, Spain
Hosp Reina Sofia, IMIBIC, Cordoba, Spain
IMIBIC, Cordoba, Spain
Taxonera, C:
Hosp Clin San Carlos, Gastroenterol Unit, Madrid, Spain
Domenech, E:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Unit, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, CIBERehd, Badalona, Spain
CIBERehd, Barcelona, Spain
Manosa, M:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Unit, Badalona, Spain
CIBERehd, Badalona, Spain
Mendoza, I:
Hosp Univ Puerta Hierro Majadahonda, Gastroenterol Unit, Majadahonda, Spain
Minguez, M:
Hosp Clin Univ Valencia, Gastroenterol Unit, Valencia, Spain
Arguelles, F:
Hosp Univ Virgen Macarena, Gastroenterol Unit, Seville, Spain
Parga, L:
Complejo Hosp Univ Vigo, Gastroenterol Unit, Vigo, Spain
Arroyo, M:
Hosp Clin Univ Lozano Blesa, Gastroenterol Unit, Zaragoza, Spain
CIBERehd Zaragoza, Zaragoza, Spain
Lopez-Sanroman, A:
Hosp Univ Ramon y Cajal, Gastroenterol Unit, Madrid, Spain
Tirado, M:
Hosp Univ Marques Valdecilla, Gastroenterol Unit, Santander, Spain
Guardiola, J:
Hosp Univ Bellvitge, Hosp Llobregat, Gastroenterol Unit, Barcelona, Spain
Arranz, M:
Hosp Univ La Paz, Gastroenterol Unit, Madrid, Spain
Beltran, B:
Hosp Univ & Politecn La Fe, Gastroenterol Unit, Valencia, Spain
CIBERehd, Valencia, Spain
Barrio, J:
Hosp Univ Rio Hortega, Gastroenterol Unit, Valladolid, Spain
Riestra, S:
Hosp Univ Cent Asturias, Gastroenterol Unit, Oviedo, Spain
Garcia-Planella, E:
Hosp Santa Creu & Sant Pau, Gastroenterol Unit, Barcelona, Spain
Calvet, X:
Hosp Parc Tauli, Gastroenterol Unit, Sabadell, Spain
CIBERehd, Sabadell, Spain
Alcain, G:
Hosp Univ Virgen Victoria, Gastroenterol Unit, Malaga, Spain
Sicilia, B:
Complejo Asistencial Univ Burgos, Gastroenterol Unit, Burgos, Spain
Garcia, S:
Hosp Univ Miguel Servet, Gastroenterol Unit, Zaragoza, Spain
Esteve, M:
Hosp Univ Mutua Terrassa, Gastroenterol Unit, Terrassa, Spain
CIBERehd, Terrassa, Spain
Marquez, L:
Hosp del Mar, Gastroenterol Unit, Barcelona, Spain
Salazar, L:
Hosp Clin Univ Valladolid, Gastroenterol Unit, Valladolid, Spain
:
Hosp Gen Univ Alicante, Gastroenterol Unit, Alicante, Spain
CIBERehd, Alicante, Spain
Piqueras, M:
Consorci Sanitari Terrassa, Gastroenterol Unit, Tarrasa, Spain
Bermejo, F:
Hosp Univ Fuenlabrada & Inst Invest La Paz IdiPaz, Madrid, Spain
Calle, J:
Hosp Univ Fdn Alcorcon, Gastroenterol Unit, Alcorcon, Spain
Hinojosa, J:
Hosp Manises, Gastroenterol Unit, Manises, Spain
Perez, A:
Hosp Univ Salamanca, Gastroenterol Unit, Salamanca, Spain
Aldeguer, X:
Hosp Univ Doctor Josep Trueta, Gastroenterol Unit, Girona, Spain
Sepulcre, M:
Hosp Gen Univ Elche, Gastroenterol Unit, Elche, Spain
Bujanda, L:
Hosp Univ Donostia, Gastroenterol Unit, San Sebastian, Spain
CIBERehd, San Sebastian, Spain
Montiel, P:
Hosp Univ 12 Octubre, Gastroenterol Unit, Madrid, Spain
Poyatos, R:
Hosp Gen Univ Ciudad Real, Gastroenterol Unit, Ciudad Real, Spain
Gutierrez, C:
Complejo Hosp Navarra, Gastroenterol Unit, Pamplona, Spain
Merino, O:
Hosp Univ Cruces, Gastroenterol Unit, Baracaldo, Spain
Cabriada, J:
Hosp Galdakao, Gastroenterol Unit, Galdakao, Spain
Roncero, O:
Complejo Hosp Mancha Ctr, Gastroenterol Unit, Alcazar De San Juan, Spain
Cara, P:
Hosp Gen Univ Santa Lucia, Gastroenterol Unit, Cartagena, Spain
Navarro-Llavat, M:
Hosp St Joan Despi Moises Broggi, Gastroenterol Unit, Sant Joan Despi, Spain
Ber, Y:
Hosp Gen San Jorge, Gastroenterol Unit, Huesca, Spain
Madrigal, R:
Complejo Hosp De Palencia, Gastroenterol Unit, Palencia, Spain
Van Domselaar, M:
Hosp Univ Torrejon, Gastroenterol Unit, Torrejon De Ardoz, Spain
Barreiro-de Acosta, M:
Hosp Clin Univ Santiago, Gastroenterol Unit, Santiago De Compostela, Spain
Llao, J:
Hosp St Joan Deu Althaia, Gastroenterol Unit, Manresa, Spain
Ramos, L:
Hosp Univ Canarias, Gastroenterol Unit, San Cristobal la Laguna, Spain
Riera, J:
Hosp Son Llatzer, Gastroenterol Unit, Palma De Mallorca, Spain
Villarin, A:
Hosp Gen Tomelloso, Gastroenterol Unit, Tomelloso, Spain
Gonzalez, E:
Hosp Univ Nuestra Senora Candelaria, Gastroenterol Unit, Santa Cruz De Tenerife, Spain
Malaves, J:
Hosp Gen Univ Valencia, Gastroenterol Unit, Valencia, Spain
Villafranca, C:
Hosp Univ Basurto, Gastroenterol Unit, Bilbao, Spain
Almela, P:
Hosp Gen Univ Castellon, Gastroenterol Unit, Castellon de La Plana, Spain
Charro, M:
Hosp Royo Villanova, Gastroenterol Unit, Zaragoza, Spain
de la Piscina, P:
Hosp Univ Araba, Gastroenterol Unit, Vitoria, Spain
Sese, E:
Hosp Arnau Vilanova, Gastroenterol Unit, Lerida, Spain
Lacruz, A:
Hosp Viladecans, Gastroenterol Unit, Viladecans, Spain
Khorrami, S:
Hosp Univ Son Dureta, Gastroenterol Unit, Palma De Mallorca, Spain
Alvarado, V:
Hosp Gen Granollers, Gastroenterol Unit, Granollers, Spain
Gil, J:
Hosp Gen Segovia, Gastroenterol Unit, Segovia, Spain
Martinez, A:
Complejo Hosp Jaen, Gastroenterol Unit, Jaen, Spain
Villaroya, R:
Hosp Univ Infanta Sofia, Gastroenterol Unit, San Sebastian Los Reyes, Spain
Acevedo, J:
Hosp Comarcal St Jaume Calella, Gastroenterol Unit, Calella, Spain
Herola, A:
Hosp Marina Baixa, Gastroenterol Unit, Villajoyosa, Spain
Villalba, L:
Hosp Santos Reyes, Gastroenterol Unit, Aranda Del Duero, Spain
Munoz, E:
Hosp Vega Baja, Gastroenterol Unit, San Bartolome, Spain
Duran, M:
Hosp Can Misses, Gastroenterol Unit, Ibiza, Spain
Menacho, M:
Hosp Univ Joan XXIII, Gastroenterol Unit, Tarragona, Spain
Lopez, V:
Hosp Materno Infantil, Pediat Gastroenterol & Nutr Unit, Malaga, Spain
Retamero, M:
Hosp Comarcal Axarquia, Malaga, Spain
Bernardo, D:
Hosp Univ de La Princesa, Gastroenterol Unit, IIS IP, Madrid, Spain
CIBERehd, Madrid, Spain
Muriel, A:
Ramon & Cajal Hosp, Biostat Unit, Madrid, Spain
Inst Ramon y Cajal Invest Sanitaria IRYCIS, CIBERESP, Madrid, Spain
Gisbert, J:
Hosp Univ de La Princesa, Inst Invest Sanitaria Princesa IIS IP, Gastroenterol Unit, Madrid, Spain
Hosp Univ de La Princesa, CIBERehd, Madrid, Spain
Hosp Univ de La Princesa, Gastroenterol Unit, IIS IP, Madrid, Spain
CIBERehd, Madrid, Spain
|