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Does Azathioprine induce endoscopic and histologic healing in pediatric inflammatory bowel disease? A prospective,

Francesca Paola Giugliano1, Caterina Strisciuglio2, Massimo Martinelli1

  • 1Department of Translational and Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|November 28, 2017
PubMed

Insights

Pediatric inflammatory bowel disease (IBD) patients on Azathioprine achieved endoscopic healing but not histological remission after 52 weeks. This highlights the need for further research into achieving complete remission in pediatric IBD.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Pharmacological Treatments

Background:

  • Mucosal healing is a key goal for pediatric inflammatory bowel diseases (IBD) remission.
  • Evaluating treatment efficacy requires assessing both endoscopic and histologic healing.

Purpose of the Study:

  • To assess endoscopic and histologic healing in pediatric Ulcerative Colitis (UC) and Crohn's disease (CD) patients.
  • To determine healing after 52 weeks of Azathioprine treatment in clinically remissive IBD patients.

Main Methods:

  • Prospective enrollment of pediatric IBD patients initiating Azathioprine.
  • Colonoscopy with macroscopic scoring (Mayo/simplified endoscopic score) at 52 weeks.
  • Histologic assessment and inflammatory marker analysis, including fecal calprotectin.

Main Results:

  • Endoscopic healing observed in 76.9% of UC and 47.6% of CD patients.
  • Significant decrease in endoscopic scores (Mayo and simplified endoscopic) at 52 weeks.
  • No significant change in histologic scores; no correlation between endoscopic and histologic healing.

Conclusions:

  • Azathioprine facilitates endoscopic healing in pediatric IBD patients.
  • Histological remission is not consistently achieved with Azathioprine at 52 weeks.
  • Further strategies are needed to achieve complete mucosal healing in pediatric IBD.
Abstract

Keywords:
ChildrenIBDMucosal healingThiopurines

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