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Early Treatment Response Predicts Outcome in Paediatric Ulcerative Colitis


Gasparetto, Marco*,†; Wong-Spracklen, Vivien; Torrente, Franco; Howell, Kate*; Brennan, Mary; Noble-Jamieson, Gabriele; Heuschkel, Robert; Zilbauer, Matthias*,†

Journal of Pediatric Gastroenterology and Nutrition: August 2018 - Volume 67 - Issue 2 - p 217–220
doi: 10.1097/MPG.0000000000001941
Short Communications: Gastroenterology: Inflammatory Bowel Disease

ABSTRACT The disease course of children with ulcerative colitis (UC) varies substantially. Published data on predictors of disease outcomes in children remain scarce. We validate clinical predictors of outcomes in 93 children with UC in a single centre (age range: 2–18 years, minimum follow-up: 18 months). We stratified children into 3 groups according to their disease course, that is, 1 = mild (38/93, 40.9%), 2 = moderate (38/93, 40.9%), 3 = severe (17, 18.2%). Comparison of clinical and biochemical parameters was performed between groups using Chi-square, Mann-Whitney, and log-rank tests. Predictors of a severe disease course included pancolitis (P 0.01), low albumin (P 0.005), low haemoglobin at diagnosis (P 0.04), paediatric ulcerative colitis activity index (PUCAI) at 3 months, and nonresponse to steroids at 3 months (P 0.0001). In our cohort, failure to achieve remission at 3 months implied an 80% likelihood to require biologics or major surgery within 18 months. A specific 3-month review point is recommended to guide future management.

*Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital

Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.

Address correspondence and reprint requests to Matthias Zilbauer, MD, PhD, MRCPCH, University Department of Paediatrics, Level 8 Addenbrooke's Hospital, Box 116, Hills Rd, Cambridge, CB2 0QQ UK (e-mail:

Received 12 November, 2017

Accepted 11 February, 2018

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (

Conflicts of Interest and Source of Funding: nothing to declare.

MG, VW-S, RH, and MZ contributed equally to this work.

MG and VW-S are the co-first authors.

© 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,