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D'Arcangelo G, Abi Nader E, Charbit-Henrion F, et al. Increased Use of Anti-Tumor Necrosis Factor Following the Implementation of the ECCO-ESPGHAN Guidelines and its Impact on the Outcome of Pediatric Crohn's Disease: A Retrospective Single-Center Study. J Pediatr Gastroenterol Nutr. 2022;74(1):79-84doi: 10.1097/MPG.0000000000003301.
D'Arcangelo, G., Abi Nader, E., Charbit-Henrion, F., Talbotec, C., Goulet, O., Ruemmele, F. M., & Pigneur, B. (2022). Increased Use of Anti-Tumor Necrosis Factor Following the Implementation of the ECCO-ESPGHAN Guidelines and its Impact on the Outcome of Pediatric Crohn's Disease: A Retrospective Single-Center Study. Journal of pediatric gastroenterology and nutrition, 74(1), 79-84. https://doi.org/10.1097/MPG.0000000000003301
D'Arcangelo, Giulia, et al. "Increased Use of Anti-Tumor Necrosis Factor Following the Implementation of the ECCO-ESPGHAN Guidelines and its Impact on the Outcome of Pediatric Crohn's Disease: A Retrospective Single-Center Study." Journal of pediatric gastroenterology and nutrition vol. 74,1 (2022): 79-84. doi: https://doi.org/10.1097/MPG.0000000000003301
D'Arcangelo G, Abi Nader E, Charbit-Henrion F, Talbotec C, Goulet O, Ruemmele FM, Pigneur B. Increased Use of Anti-Tumor Necrosis Factor Following the Implementation of the ECCO-ESPGHAN Guidelines and its Impact on the Outcome of Pediatric Crohn's Disease: A Retrospective Single-Center Study. J Pediatr Gastroenterol Nutr. 2022 Jan 01;74(1):79-84. doi: 10.1097/MPG.0000000000003301. PMID: 34962501.
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J Pediatr Gastroenterol Nutr. 2022 Jan 01;74(1):79-84. doi: 10.1097/MPG.0000000000003301.

Increased Use of Anti-Tumor Necrosis Factor Following the Implementation of the ECCO-ESPGHAN Guidelines and its Impact on the Outcome of Pediatric Crohn's Disease: A Retrospective Single-Center Study.

Journal of pediatric gastroenterology and nutrition

Giulia D'Arcangelo, Elie Abi Nader, Fabienne Charbit-Henrion, Cécile Talbotec, Olivier Goulet, Frank M Ruemmele, Bénédicte Pigneur

Affiliations

  1. Gastroenterology and Nutrition Unit, Necker - Enfants Malades Hospital, APHP, Université de Paris, Faculté de Médecine, Paris, France.
  2. Department of Women's and Children's Health, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy.
  3. INSERM UMR 1163, Immunité intestinale, Institut Imagine.
  4. INSERM UMR S 1139, Faculté de Pharmacie de Paris, Université de Paris, Paris, France.

PMID: 34962501 DOI: 10.1097/MPG.0000000000003301

Abstract

OBJECTIVES: The first ECCO-ESPGHAN guidelines for the medical management of pediatric Crohn disease (CD) were published in 2014. Whether their implementation, and the consequent increased use of an upfront anti-tumor necrosis factor therapy, have changed the course of the disease has not been investigated yet. We aimed at comparing the evolution of pediatric CD patients diagnosed and treated before and after 2014.

METHODS: Single-center retrospective study including all children diagnosed with CD from January 2010 to December 2018. Patients diagnosed between 2010 and 2014 (group 1) were compared to those diagnosed after 2014 (group 2). For each patient, at baseline and every 6-month, number of relapses, the occurrence of complication, therapy received and biological parameters were noted, as well as any endoscopic or radiologic evaluation.

RESULTS: One hundred and fifty-four patients were included in the analysis, 78 (51%) diagnosed after 2014. The cumulative probability of a relapse-free and surgery-free course was significantly higher for patients treated according to the guidelines (log rank hazard ratio [HR] = 1,818, P = 0.003 and HR = 3,15, 95% confidence interval, P = 0.04, respectively). Mucosal healing rate was significantly higher among patients of group 2 at 1 and 2 years (P = 0.04 and P = 0.05, respectively), while no significant difference was observed for transmural healing rates, as well as for the risk of complications.

CONCLUSIONS: The implementation of the 2014 CD guidelines appears to have a significant impact on disease outcomes, with a significantly lower risk for relapse and surgery, while no effect could be observed on the risk of developing complications.

Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Conflict of interest statement

F.M.R. last 3 years received consultation fee, research grant, or honorarium from Janssen, Pfizer, Abbvie, Takeda, Celgene, Nestlé Health Science, Nestlé Nutrition Institute. O.G. received financial s

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