Predictors for poor outcome of hospitalized children with inflammatory bowel disease

Yerushalmy‐Feler, Anat; Singer, Dana; Berkovitch, Gil; Lubetzky, Ronit; Dotan, Iris; Ziv‐Baran, Tomer; Cohen, Shlomi

doi:10.1007/s00431-019-03491-9

Cited by 4 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most biomarker studies in patients with IBD are either cross-sectional, in which biomarkers were compared with clinical scores [24], or one-time levels that predicted future adverse outcomes, such as complications after surgery [25], increased risk of surgery or medication [26], prolonged hospitalizations [27], or steroid non-response [28]. Newer studies have incorporated one-time levels of CRP and serum albumin, often as the CRP/serum albumin ratio (CAR) [24].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Measurements of Blood Biomarkers in Patients with Crohn’s Disease or Ulcerative Colitis Treated with Infliximab: Only the Latest Values in the Induction Period Predict Treatment Failure

Gradel,

Nørgård,

Friedman

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Few studies have incorporated longitudinal assessments or used combinations of blood biomarkers as predictors of loss of response to biologic therapy for patients with Crohn’s disease (CD) or ulcerative colitis (UC). Methods: This is a population-based cohort study comprising Danish patients with CD or UC from 2008 to 2018. We used logistic regression to analyze whether levels and changes in levels of C-reactive protein (CRP), serum albumin, and hemoglobin, routinely measured during a 14-week infliximab induction period, predicted a change to another biologic medication or cessation of biologic therapy. Results: During the induction period, 2883 (1626 CD, 1257 UC) patients had 12,730, 12,040, and 13,538 specimens with CRP, serum albumin, and hemoglobin, respectively. In all, 284 patients (9.9%) switched to another biologic medication, and 139 (4.8%) ceased biologic therapy in the follow-up period. Only the most recent CRP and hemoglobin levels predicted the efficacy of infliximab treatment at approximately 14 weeks, a time point when the clinician often determines whether to continue treatment. Conclusion: Measurement of blood biomarkers prior to the clinical assessment does not predict the effectiveness of infliximab.

show abstract

Section: Discussionmentioning

confidence: 99%

Longitudinal Measurements of Blood Biomarkers in Patients with Crohn’s Disease or Ulcerative Colitis Treated with Infliximab: Only the Latest Values in the Induction Period Predict Treatment Failure

Gradel,

Nørgård,

Friedman

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, this is the first study to describe indications of hospitalization in pediatric IBD in the era of biologic therapy. The major strength of our study lies in the data having been based on a large demographic and clinical database of children with IBD [49], that enabled us to specifically analyze patients receiving biologic therapy. The study is limited by its retrospective nature and by the challenge to correctly differentiate between disease exacerbation and therapyrelated adverse events.…”

Section: Discussionmentioning

confidence: 99%

Biologic therapy is associated with a mild decrease in the rate of hospitalizations in pediatric IBD

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background The effect of biologic therapy on the incidence of inflammatory bowel disease (IBD)-related hospitalizations is controversial. The high efficacy of biologic agents is weighted against potential therapy-related adverse events, however, there are no data on the effect of biologic therapy on the indications for hospitalization in IBD. We aimed to evaluate the impact of biologic therapy on the indications and rate of hospitalization in pediatric IBD. Methods This retrospective cohort study included all children (< 18 years of age) with IBD who were hospitalized in our medical center from January 2004 to December 2019. Data on demographics, disease characteristics and course, and therapy were collected, as were the indications for and course of hospitalizations. We evaluated the relationship between therapy with biologic agents, indications and rates of hospitalization. Results Included were 218 hospitalizations of 100 children, of whom 65 (65%) had Crohn’s disease and 35 (35%) had ulcerative colitis. The indications for hospitalization were IBD exacerbations or complications in 194 (89%) and therapy-related adverse events in 24 (11%). The patients of 56 (25.7%) hospitalizations were receiving biologic therapy. In a multivariate analysis, no correlation between therapy and indication for hospitalization was found (p = 0.829). Among children under biologic therapy, a decrease in the rate of hospitalizations from 1.09 (0.11–3.33) to 0.27 (0–0.47) per year was observed for patients that were hospitalized during 2016–2019 (p = 0.043). Conclusion Biologic therapy did not influence the indication for hospitalization, but were associated with a decrease in the rate of hospitalization during 2016–2019 in pediatric IBD.

show abstract

“…Epidemiologic factors, including race and ethnicity (black and Hispanic patients [72]), need for hospitalization [73,74], and prior anti-TNF, thiopurine, and steroid exposure [75,76] have all been associated with poor outcomes in patients with ASUC. Studies in the pediatric population have identified low weight percentile as an additional predictor of poor outcomes in this age group [77]. Clinical findings, such as fever, increased frequency of bowel movements, and presence of blood in stool, have been associated with risk for urgent or emergent colectomy [8][9][10]78].…”

Section: Predictors Of Poor Outcomesmentioning

confidence: 99%

Management of Hospitalized Patient with Ulcerative Colitis Refractory to Corticosteroids

Rabinowitz

Gold

Maser

2021

Management of Inpatient Inflammatory Bowel Disease

View full text Add to dashboard Cite

Predictors for poor outcome of hospitalized children with inflammatory bowel disease

Cited by 4 publications

References 19 publications

Longitudinal Measurements of Blood Biomarkers in Patients with Crohn’s Disease or Ulcerative Colitis Treated with Infliximab: Only the Latest Values in the Induction Period Predict Treatment Failure

Longitudinal Measurements of Blood Biomarkers in Patients with Crohn’s Disease or Ulcerative Colitis Treated with Infliximab: Only the Latest Values in the Induction Period Predict Treatment Failure

Biologic therapy is associated with a mild decrease in the rate of hospitalizations in pediatric IBD

Management of Hospitalized Patient with Ulcerative Colitis Refractory to Corticosteroids

Contact Info

Product

Resources

About