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The Evolving Effectiveness of Biologics in Avoiding Surgery in Children With Ulcerative Colitis: At what Nutritional

Mohineesh Kumar1,2, Rachel N Harvey2, Samuel K Osei1,2

  • 1Department of Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.

The American Surgeon
|March 4, 2023
PubMed

Insights

New biologics improve remission rates in pediatric ulcerative colitis (UC). Surgery significantly improves nutrition and remission, even in medically refractory cases, suggesting a reevaluation of treatment strategies for pediatric UC patients.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Clinical Therapeutics

Background:

  • Pediatric ulcerative colitis (UC) management has evolved with biologic therapies.
  • Assessing the impact of biologics on remission, nutrition, and surgery is crucial.

Purpose of the Study:

  • To evaluate the effectiveness of biologic therapies in pediatric UC.
  • To analyze the impact of biologics and surgery on nutritional status and remission rates.

Main Methods:

  • Retrospective analysis of hospital records for 115 UC patients (ages 1-19).
  • Patients categorized into groups: no biologics/surgery, one biologic, multiple biologics, or colectomy.
  • Follow-up duration averaged 5.9 years.

Main Results:

  • Remission rates varied: 58% (no biologics), 71% (one biologic), 29% (multiple biologics), 100% (surgery).
  • 55% of surgical patients underwent colectomy within the first year.
  • Body Mass Index (BMI) improved post-surgery (P=0.001); nutrition did not improve with additional biologics.

Conclusions:

  • Biologics are transforming pediatric UC remission maintenance.
  • The need for surgery in pediatric UC is lower than previously reported.
  • Surgery offers significant nutritional and remission benefits in medically refractory UC.
Abstract

Keywords:
Ulcerative colitisbiologicsinfliximabpediatric ulcerative colitis

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