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Current health status and medical therapy of patients with pediatric-onset inflammatory bowel disease: a survey-based analysis on 1280 patients aged 10–25 years focusing on differences by age of onset

Timmer, Antjea,b; Stark, Reneec,e; Peplies, Jennyb,c; Classen, Martind; Laass, Martin W.g; Koletzko, Sibyllef

European Journal of Gastroenterology & Hepatology: November 2017 - Volume 29 - Issue 11 - p 1276–1283
doi: 10.1097/MEG.0000000000000956
Original Articles: Inflammatory Bowel Disease

Objective There are inconsistent reports on age-related differences in inflammatory bowel disease (IBD). On the basis of patient information, we describe the clinical presentation and therapy in relation to age at diagnosis in longstanding pediatric IBD.

Patients and methods Two surveys were conducted in children and young adults (age: 10–25 years) by pretested postal questionnaires. The main analyses are descriptive, showing proportions and distributions per grouped age of diagnosis. Exploratory logistic regression was used to identify sociodemographic and disease-related factors associated with prognosis. Recent disease course, use of biological therapy, and resecting surgery were chosen as indicators of disease severity. Patients with a diagnosis in infancy (<2 years of age) are presented as a case series.

Results Information of 1280 cases was available [804 Crohn’s disease (CD), 382 ulcerative colitis (UC), 94 IBD not specified] (response: 44.6 and 49.6%). Stable remission during the preceding year was reported by 675 (56.7%) patients; 825 (60.9%) patients reported feeling currenty well. Anti-tumor necrosis factor therapy was reported by 33% of CD patients and 9.3% of UC patients, immunomodulation in 82.1 and 63.2%, and corticosteroids by 78.4 and 76.1%, respectively (ever use). Age at diagnosis was not associated with indicators of severe disease. Diagnosis in infancy was reported by 37 patients.

Conclusion Our data do not support age at diagnosis-related differences in prognosis in pediatric-onset IBD.

aDepartment of Health Services Research, Medical Faculty, Division of Epidemiology and Biometry, Carl von Ossietzky University, Oldenburg

bDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS GmbH

cFaculty of Human and Health Sciences, Institute for Public Health and Nursing Research IPP

dChildrens Hospital, Klinikum Links der Weser, Bremen

eInstitute for Health Economics and Healthcare Management, Helmholtz Zentrum München, Neuherberg

fDr. von Hauner Children’s Hospital, Ludwig Maximilian University, Munich

gChildren’s Hospital, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany

Correspondence to Antje Timmer, MSc, Department of Health Services Research, Division of Epidemiology and Biometry, Medical Faculty, Carl von Ossietzky Universität Oldenburg, 26111 Oldenburg, Germany Tel: +49 441 798 4437; fax: +49 441 798 5824; e-mail:

Received March 6, 2017

Accepted July 11, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.