Letter: Differences in Disease Characteristics and Treatment Exposures Between Paediatric and Adult-Onset IBD

Abstract

We read with great interest the article by Granot et al. which offers valuable insights into the varying disease characteristics and treatment strategies in paediatric versus adult-onset inflammatory bowel disease (IBD) [1]. While the study highlighted several important findings, we believe additional considerations warrant further exploration.

First, the article presents a crucial juxtaposition of using biologics versus immunomodulators in both paediatric and adult patients with IBD. Yet, the long-term risks associated with biologics and immunomodulators in children remain insufficiently researched. Despite the success of these treatments in managing illness, they are associated with heightened vulnerability to infections and cancer, and influence growth and development [2]. Future studies should concentrate on determining the long-term safety of these medications in children, incorporating methods to lessen risks while preserving disease management.

Second, although the piece covered various ages of treatment exposure, it fell short of comprehensively highlighting the significance of tailoring treatment approaches. Biologics have divergent effects on paediatric patients compared to adults, attributed to variances in immune response, disease characteristics and genetics [3]. Future studies need to focus on tailored treatment methods, such as drug-based genetic testing and analysing disease types, to achieve the best outcomes in both children and adults.

Third, the paper emphasised the urgency of aggressive intervention for paediatric onset IBD, yet overlooked the psychological and quality of life impacts of IBD in younger patients. Prolonged illness during childhood can significantly impact mental well-being, social dynamics and academic achievements [4]. Incorporating evaluations of mental wellness and quality of life into therapeutic strategies is vital for the holistic care of children suffering from IBD.

In conclusion, although this research offers a crucial understanding of managing IBD in both children and adults, future studies should concentrate on assessing the long-term safety of biologics, highlight the significance of tailored treatments and take into account the wider psychological and social effects of IBD.

Xinli Chen: writing – original draft. Wenjun Wang: conceptualization, writing – review and editing, supervision. Jianyu Lv: conceptualization, writing – original draft.

The authors declare no conflicts of interest.

This article is linked to Granot et al paper. To view this article, visit https://doi.org/10.1111/apt.18264.