Related Experiment Videos

The ImproveCareNow Registry: Prediction of remission rates in paediatric Crohn's disease

Jonathan Van Hecke1, Gigi Veereman2, Koen Huysentruyt2

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

Journal of Pediatric Gastroenterology and Nutrition
|July 28, 2026
PubMed

Insights

Female sex, younger age, and higher BMI predict poor outcomes in pediatric Crohn's disease (CD). Early or late use of biologics also impacts remission time, guiding future therapeutic strategies for pediatric CD patients.

Area of Science:

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

Background:

  • Identifying predictors of poor outcomes (POPO) in pediatric Crohn's disease (CD) is crucial for optimizing treatment strategies.
  • Previous studies have explored various factors, but a comprehensive analysis of predictors for both short-term and long-term remission is needed.

Purpose of the Study:

  • To assess predictors of 2-year non-remission in pediatric CD patients.
  • To evaluate factors influencing time to first remission (TFR), corticosteroid-free remission (TCSFR), and sustained remission (TSR).

Main Methods:

  • Retrospective analysis of prospectively collected data from 6959 pediatric CD patients (2007-2023) from the ImproveCareNow Registry.
  • Remission defined as Pediatric CD Activity Index <10. Logistic and Cox regression models were used with multiple imputation to identify predictors.

Main Results:

  • Female sex and later ustekinumab use predicted non-remission at 2 years.
  • Female sex and infliximab (IFX) use at the first visit predicted longer TFR.
  • Female sex, white race, and IFX treatment were associated with longer TCSFR, while Asian race and CS/immunomodulator use were linked to longer TCSFR.
  • Older age at diagnosis and higher BMI predicted longer TSR.

Conclusions:

  • Clinical factors like female sex, younger age, and higher BMI are associated with poor outcomes in pediatric CD.
  • Therapeutic strategies, including the timing of biologic use, significantly influence remission.
  • These findings can guide personalized treatment approaches for pediatric CD.
Abstract

Keywords:
disease courseinflammatory bowel diseasepaediatrics

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Inflammatory Bowel Disease III: Crohn's Disease01:25

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...