Mucosal healing is not associated with better outcome during 7 years of follow-up in pediatric patients with Crohn's disease.

IF 1 Q3 PEDIATRICS Minerva Pediatrics Pub Date : 2024-06-01 Epub Date: 2021-04-12 DOI:10.23736/S2724-5276.21.06099-0
Jan Melek, Markéta Štanclová, Petr Dědek, Radek Štichhauer, Jaroslav Koudelka, Tomáš Douda, Ilja Tachecí, Ladislav Douda, Tomáš Vaňásek, Jan Bureš
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Abstract

Background: Mucosal healing (MH) has become a perspective treatment target in patients with Crohn's disease (CD). Data about the impact of MH on long-term outcome in pediatric patients are still scarce.

Methods: Seventy-six pediatric patients with CD were evaluated retrospectively (2000-2015) in a tertiary care center. Based on MH achievement, they were divided into two groups (MH, N.=17; and No MH, N.=59). The primary endpoint was to assess the association of MH and the need for CD-related hospitalizations or surgery in pediatric patients with CD.

Results: The number of hospitalized patients was 24% in the MH group and 42% in the No MH group (P=0.26). The total number of CD-related hospitalizations was not significant between the MH group and the No MH group (5 vs. 41, P=0.15). The time to the first hospitalization was 24 months in MH and 21 months in No MH (P>0.99). About 24% of the patients in the MH group and 39% patients in the No MH group underwent CD-related operation (P=0.39). Time to the first operation was 43 months for MH and 19 months for the No MH group (P=0.13). The follow-up period was 91 months in the MH group and 80 months in the No MH group (P=0.74). The use of infliximab was positively associated with MH (P=0.002).

Conclusions: MH was not associated with fewer CD-related hospitalizations or operations in pediatric patients with CD during seven years of follow-up.

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在对克罗恩病儿童患者进行的 7 年随访中,粘膜愈合与更好的治疗效果无关。
背景:黏膜愈合(MH)已成为克罗恩病(CD)患者的治疗目标。方法:一家三级医疗中心对 76 名儿童 CD 患者进行了回顾性评估(2000-2015 年)。根据MH结果,他们被分为两组(MH组,17人;无MH组,59人)。主要终点是评估MH与儿童CD患者CD相关住院或手术需求的关系:MH组住院患者人数为24%,无MH组为42%,P=0.26。MH组与无MH组的CD相关住院总人数差异不大(5 vs. 41,P = 0.15)。MH组患者的首次住院时间为24个月,无MH组患者的首次住院时间为21个月,P>0.99。MH组有24%的患者接受了CD相关手术,无MH组有39%的患者接受了CD相关手术,P = 0.39。MH组首次手术时间为43个月,无MH组为19个月,P = 0.13。MH组的随访时间为91个月,无MH组为80个月,P = 0.74。使用英夫利昔单抗与MH呈正相关,P = 0.002:结论:在7年的随访中,MH与减少儿童CD患者与CD相关的住院或手术无关。
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