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Aliment Pharmacol Ther. 2011 Nov;34(10):1217-24. doi: 10.1111/j.1365-2036.2011.04857.x. Epub 2011 Oct 9.

Differences in phenotype and disease course in adult and paediatric inflammatory bowel disease--a population-based study.

Author information

1
Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark. christian.jakobsen@hvh.regionh.dk

Erratum in

  • Aliment Pharmacol Ther. 2012 Apr;35(7):864.

Abstract

BACKGROUND:

Few studies have compared phenotype and disease course in children and adults with inflammatory bowel disease (IBD).

AIM:

  To compare phenotype, treatment and disease course in children (<15 years) and adults (≥18 years) with IBD.

METHODS:

Two population-based cohorts comprising paediatric (2001-2006) and adult (2003-2004) patients from Copenhagen County and City were studied.

RESULTS:

Twenty children and 106 adults with ulcerative colitis (UC), and 29 children and 67 adults with Crohn's disease (CD) were included. Median follow-up time was 4.8 years (children) and 5.2 years (adults). Children with UC had more extensive disease compared to adult patients [14 (70%) vs. 20 (19%), P<0.001]. The risks of starting systemic steroid treatment and AZA/MP were higher for paediatric UC patients compared to adult UC patients; hazard ratio (HR): 3.1 (95% CI: 1.8-5.3) and HR: 2.5 (1.3-5-9), respectively. Steroid dependency was more frequent in paediatric than in adult UC patients [9 (45%) vs. 9 (8%), P<0.001]. Mild disease course was less frequent in children with UC compared to adult patients [7 (35%) vs. 76 (72%), P=0.002]. Paediatric and adult CD patients did not differ regarding treatment or disease course. Cumulative 5-year surgery rates for paediatric and adult patients were 5% and 9% for UC (N.S.) and 18% and 21% for CD (N.S.), respectively.

CONCLUSIONS:

Paediatric UC patients had more extensive disease, were more often treated with systemic steroids and AZA, had a higher frequency of steroid dependency and a more severe disease course compared to adult UC patients. No differences were found when comparing paediatric and adult CD patients.

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