De Greef Elisabeth, Hoffman Ilse, Smets Francoise, Van Biervliet Stephanie, Bontems Patrick, Hauser Bruno, Paquot Isabelle, Alliet Philippe, Arts Wim, Dewit Olivier, De Vos Martine, Baert Filip, Bossuyt Peter, Rahier Jean-Francois, Franchimont Denis, Vermeire Severine, Fontaine Fernand, Louis Edouard, Coche J C, Veereman Gigi
*Paediatric Gastroenterology, UZ Brussel †Free university Brussels (VUB), Brussel ‡Paediatric Gastroenterology, UZ Gasthuisberg, Leuven §Paediatric Gastroenterology, UCL St Luc, Brussel ||Paediatric Gastroenterology, UZ Gent, Gent ¶Pediatric Gastroenterology, HUDERF, Brussel #Pediatric Gastroenterology, CHC Espérance, Liège **Paediatric Gastroenterology, Jessa Hospital, Hasselt ††Paediatric Gastroenterology, ZOL, Genk ‡‡Gastroenterology, UCL St Luc, Brussel §§Gastroenterology, UZ Gent, Gent ||||Gastroenterology,H Hart Hospital, Roeselare ¶¶Gastroenterology, Imelda Hospital, Bonheiden ##Gastroenterology, UCL Mont Godinne, Mont Godinne ***Gastroenterology, ULB Erasme, Brussel †††Gastroenterology, UZ Gasthuisberg, Leuven ‡‡‡Gastroenterology, CHU St Joseph §§§Gastroenterology, CHU and University of Liège, Liège ||||||Gastroenterology, Clinique St Pierre, Ottignies, Belgium.
J Pediatr Gastroenterol Nutr. 2016 Aug;63(2):253-8. doi: 10.1097/MPG.0000000000001132.
The Belgian registry for paediatric Crohn disease (BELCRO) cohort is a prospective, multicentre registry for newly diagnosed paediatric patients with Crohn disease (CD) (<18 years) recruited from 2008 to 2010 to identify predictive factors for disease activity and growth.
Data from the BELCRO database were evaluated at diagnosis, 24 and 36 months follow-up.
At month 36 (M36), data were available on 84 of the 98 patients included at diagnosis. Disease activity evolved as follows: inactive 5% to 70%, mild 19% to 24%, and moderate to severe 76% to 6%. None of the variables such as age, sex, diagnostic delay, type of treatment, disease location, disease activity at diagnosis, and growth were associated with disease activity at M36. Paediatricians studied significantly less patients with active disease at M36 compared with adult physicians. Sixty percent of the patients had biologicals as part of their treatment at M36. Adult gastroenterologists initiated biologicals significantly earlier. They were the only factor determining biologicals' initiation, not disease location or disease severity at diagnosis. Median body mass index (BMI) z score evolved from -0.97 (range -5.5-2.1) to 0.11 (range -3.4-2) and median height z score from -0.15 (range -3.4-1.6) to 0.12 (range -2.3-2.3) at M36. None of the variables mentioned above influenced growth over time.
Present treatment strategies lead to good disease control in the BELCRO cohort after 3 years. Logistic regression analysis did not show any influence of disease location or present treatment strategy on disease activity and growth, but patients under paediatric care had significantly less severe disease at M36.
比利时儿童克罗恩病登记处(BELCRO)队列研究是一项前瞻性、多中心登记研究,纳入了2008年至2010年新诊断的18岁以下儿童克罗恩病(CD)患者,以确定疾病活动和生长的预测因素。
对BELCRO数据库的数据在诊断时、随访24个月和36个月时进行评估。
在36个月(M36)时,可获得诊断时纳入的98例患者中84例的数据。疾病活动演变如下:非活动从5%至70%,轻度从19%至24%,中度至重度从76%至6%。年龄、性别、诊断延迟、治疗类型、疾病部位、诊断时疾病活动度和生长等变量均与M36时的疾病活动度无关。与成年医生相比,儿科医生在M36时研究的活动期疾病患者明显更少。60%的患者在M36时接受了生物制剂治疗。成年胃肠病学家更早开始使用生物制剂。他们是决定开始使用生物制剂的唯一因素,而非诊断时的疾病部位或疾病严重程度。M36时,体重指数(BMI)z评分中位数从-0.97(范围-5.5至2.1)变为0.11(范围-3.4至2),身高z评分中位数从-0.15(范围-3.4至1.6)变为0.12(范围-2.3至2.3)。上述变量均未随时间影响生长。
目前治疗策略使BELCRO队列在3年后实现了良好的疾病控制。逻辑回归分析未显示疾病部位或当前治疗策略对疾病活动度和生长有任何影响,但在M36时,接受儿科护理的患者疾病严重程度明显较低。