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The Influence of the Introduction of Biologic Agents on Surgical Intervention in Paediatric Inflammatory Bowel

George S Bethell1,2, James J Ashton3,4, Stephen Adams2

  • 1From the University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK.

Journal of Pediatric Gastroenterology and Nutrition
|June 6, 2022
PubMed

Insights

Biological therapies are linked to fewer surgeries for pediatric inflammatory bowel disease (PIBD). Further research will clarify if biologics prevent or merely delay surgical intervention in children with PIBD.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Health Services Research

Background:

  • Pediatric inflammatory bowel disease (PIBD) encompasses Crohn's disease (CD), ulcerative colitis (UC), and inflammatory bowel disease-unclassified (IBD-U).
  • Surgical intervention has historically been a common treatment for severe PIBD.
  • The advent of biological therapies has presented a new treatment paradigm for chronic inflammatory conditions.

Purpose of the Study:

  • To investigate the association between biological therapy use and surgical intervention rates in children diagnosed with PIBD.
  • To analyze population-level trends in surgical resection and biological therapy use for PIBD over time.

Main Methods:

  • Utilized Hospital Episode Statistics data from England (1997-2015) for children aged 0-18 years.
  • Included ICD-10 codes for PIBD diagnoses (CD, UC, IBD-U) and OPCS-4 codes for surgical resection and biological therapy.
  • Analyzed trends in surgical intervention and biological therapy use over the study period.

Main Results:

  • A total of 22,645 children were diagnosed with PIBD.
  • Biological therapy was used in 17.9% of cases, while 14% underwent surgical resection.
  • A significant decrease in surgical intervention rates (P=0.04) and a significant increase in biological therapy use (P<0.0001) were observed over time.

Conclusions:

  • The introduction of biologic agents has been associated with a reduction in surgical interventions for PIBD in children.
  • Ongoing observation is necessary to determine if biological therapies ultimately prevent the need for surgery or only delay it into adulthood.
Abstract

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