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The Impact of Biologic Therapies on Rate of Colectomy in Paediatric-onset Ulcerative Colitis - A Population-Based

Emma Hope1, Cameron Kuronen-Stewart1, David C Wilson2

  • 1Department of Paediatric Surgery, Royal Hospital for Children and Young People, Edinburgh, 50 Little France Crescent, Edinburgh, EH16 4TJ, UK.

Journal of Pediatric Surgery
|November 19, 2023
PubMed

Insights

Biologic therapies did not reduce colectomy rates in pediatric ulcerative colitis (UC) patients. Those receiving biologics showed a higher risk of colectomy, possibly due to increased disease severity.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Outcomes Analysis

Background:

  • Limited data exist on colectomy rates in pediatric-onset ulcerative colitis (UC).
  • Biologic therapies are used in adult UC but their impact on pediatric colectomy rates is unclear.
  • Understanding colectomy trends in pediatric UC is crucial for long-term management.

Purpose of the Study:

  • To determine colectomy rates in pediatric-onset UC.
  • To evaluate the effect of biologic therapies on colectomy risk in this population.
  • To analyze colectomy rates over time, including transition to adult care.

Main Methods:

  • Population-based cohort study of prevalent pediatric-onset UC patients in South-East Scotland (2000-2021).
  • Data collected from a prospectively accrued database and health records.
  • Kaplan-Meier analysis used to calculate cumulative colectomy risk.

Main Results:

  • 145 patients identified; 16% underwent colectomy over a median follow-up of 7.9 years.
  • 34% received biologic therapy; 57% of those who had colectomy received biologics.
  • Biologic-exposed patients had higher 5- and 10-year colectomy rates (22% and 34%).

Conclusions:

  • Defined 1-, 5-, and 10-year colectomy rates for pediatric-onset UC.
  • Biologic therapy was associated with a significantly increased colectomy risk.
  • Increased disease severity in biologic-treated patients may explain the higher colectomy risk.
Abstract

Keywords:
Biologic therapyColectomyPaediatricSurgeryUlcerative colitis

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