儿童和成人发病的炎症性肠病之间的疾病特征和治疗暴露的差异,使用基于登记册的队列队列
Maya Granot1,2, Uri Kopylov2,3, Nurit Loberman-Nachum1,2
1Division of Pediatric Gastroenterology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
Alimentary pharmacology & therapeutics
|September 11, 2024
概括
与成年人相比,患有炎症性肠病 (IBD) 的儿童患有更广泛的疾病,需要更早,更密集的治疗,包括生物药物. 这突显了儿科发病和成人发病IBD之间疾病进展和治疗的显著差异.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 儿科医学 儿科医学
- 免疫学 免疫学 免疫学
背景情况:
- 之前的研究表明,与成人发病的IBD相比,儿科发病的炎症性肠病 (IBD) 的表型更严重.
- 然而,许多先前的研究缺乏长期数据,并且早于生物疗法的广泛使用.
研究的目的:
- 对儿科发病IBD与成人发病IBD的疾病特征和治疗暴露进行比较分析.
- 评估不同IBD发病组的长期结果和治疗模式.
主要方法:
- 使用统一数据收集的登记册,对人口统计,疾病表型和治疗进行统一数据收集.
- 与2000-2022年间被诊断患有IBD的患者进行了比较,随访时间至少为12个月.
- 在儿科发病 (6-17岁) 和成人发病IBD之间进行了分层分析.
主要成果:
- 儿科发病IBD患者 (n=853) 呈现出更广泛的疾病,并且接受了比成人发病IBD患者 (n=3316) 更强化的治疗.
- 儿科发作的性结肠炎显示出更高的广泛性结肠炎率和更大的需要类固醇,免疫调节剂和生物药物.
- 儿科发病的克罗恩病表现出更多的胆结肠和围内脏干扰,增加了免疫调节剂和生物制剂的使用.
- 在儿科发病的IBD中观察到显著较低的15年无生物生存期 (p < 0.001).
结论:
- 儿科发病IBD的特点是更广泛的疾病表现.
- 患有儿科发病IBD的患者对免疫调节剂和生物疗法暴露率更高.
- 早期和更频繁的使用先进疗法是必要的儿科发病IBD比成人发病IBD.
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