J Pediatr Gastroenterol Nutr. 2022 Jun 6. doi: 10.1097/MPG.0000000000003510. Online ahead of print.
ABSTRACT
OBJECTIVES: To determine how the use of biological therapy is associated with surgical intervention for paediatric inflammatory bowel disease (PIBD) at population level.
METHODS: Hospital Episode Statistics data were obtained for all admissions within England, (1997-2015), in children aged 0-18 years, with an ICD-10 code for diagnosis of Crohn’s disease (CD), ulcerative colitis (UC) or inflammatory bowel disease-unclassified (IBD-U). OPCS codes for major surgical resection associated with PIBD and for biological therapy were also obtained. Data are presented as median values (interquartile range).
RESULTS: In total, 22,645 children had a diagnosis of PIBD of which 13,722 (61%) had CD, 7,604 (34%) UC and 1,319 (5.8%) cases IBD-U. Biological therapy was used in 4,054 (17.9%) cases. Surgical resection was undertaken in 3,212 (14%) cases, more commonly for CD than UC (17.5 vs 10.3%, p<0.0001). Time from diagnosis to major surgical resection was 8.3 (1.2-28.2) months in CD and 8.2 (0.8-21.3) months in UC. As the time-frame of the data-set progressed, there was a decreased rate of surgical intervention (p=0.04) and an increased use of biological therapy (p<0.0001). Additionally, the number of new diagnoses of PIBD increased.
CONCLUSION: The introduction of biologic agents has been associated with a reduction in cases undergoing surgery in children with a known diagnosis of PIBD. As time progresses we will be able to determine whether biological therapies prevent the need for surgery altogether or just delay this until adulthood.An infographic is available for this article at: http://links.lww.com/MPG/C846.
PMID:35666884 | DOI:10.1097/MPG.0000000000003510
