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The ImproveCareNow registry: Prediction of 2-year nonremission in pediatric ulcerative colitis

Jonathan Van Hecke1, Gigi Veereman2, Koen Huysentruyt2

  • 1Geneeskunde en Farmacie, Vrije Universiteit Brussel (VUB), Brussels, Belgium.

Journal of Pediatric Gastroenterology and Nutrition
|February 5, 2026
PubMed

Insights

Predictors of unfavorable pediatric ulcerative colitis (UC) course include higher disease severity and BMI z-score, and not using immunomodulators (IM) early on. These factors may guide early treatment strategies for UC patients.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Epidemiology

Background:

  • Pediatric ulcerative colitis (UC) poses challenges in predicting disease course.
  • Identifying early predictors of unfavorable outcomes is crucial for timely therapeutic intervention.

Purpose of the Study:

  • To define predictors of nonremission at 2 years post-diagnosis in pediatric UC patients.
  • To inform therapeutic strategies by identifying early indicators of disease severity.

Main Methods:

  • Retrospective analysis of prospectively collected data from ImproveCareNow (2007-2023).
  • Included 1290 pediatric UC patients (<18 years) with ≥2-year follow-up.
  • Used logistic regression to identify predictors of nonremission, defining remission as pediatric UC activity index (PUCAI) <10.

Main Results:

  • 30% of patients (390/1290) were not in remission at 2 years.
  • Higher PUCAI scores (mild, moderate, severe), increased BMI z-score, and non-use of immunomodulators (IM) at T1 predicted non-remission at T2.
  • Predictive ability was limited (AUC 0.599-0.621).

Conclusions:

  • Increasing disease severity (PUCAI), higher BMI z-score, and lack of early IM use are predictors of an unfavorable pediatric UC course.
  • These findings may guide therapeutic decisions shortly after diagnosis.
  • Further research may refine predictive models for pediatric UC.
Abstract

Keywords:
disease courseinflammatory bowel diseaseprognosisrisk factors

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