Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Immunology

Background:

• Limited comparative studies exist on childhood- versus adulthood-onset inflammatory bowel disease (IBD) during the biologics era.
• Understanding these differences is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare disease characteristics, treatment patterns (immunomodulators, biologics), and surgical needs in childhood-onset versus adulthood-onset IBD.
• To identify factors influencing treatment decisions in different IBD onset groups.

Main Methods:

• Analysis of the ENEIDA registry data for IBD patients diagnosed between 2007 and 2017.
• Categorization into childhood-onset (≤16 years) and adulthood-onset (>16 years) cohorts.
• Kaplan-Meier curves and Cox regression for treatment and surgery risk analysis.

Main Results:

• The childhood-onset cohort (4%) presented with higher rates of Crohn's disease, ileocolonic involvement, and inflammatory behavior.
• Childhood-onset IBD was associated with an increased risk of immunomodulator (HR=1.2) and biologic therapy (HR=1.2) use.
• No significant difference in the risk of surgery was observed between childhood- and adulthood-onset IBD (HR=0.9).

Conclusions:

• Childhood-onset IBD exhibits unique characteristics and a greater need for immunomodulatory and biologic treatments.
• Despite intensive medical treatment, pediatric IBD does not appear to carry a higher risk of surgical intervention compared to adult-onset IBD.