Grover Zubin
Department of Gastroenterology, Perth Children's Hospital, Perth, Australia.
Transl Pediatr. 2019 Jan;8(1):70-76. doi: 10.21037/tp.2019.01.03.
Paediatric-onset inflammatory bowel disease (IBD) is associated with greater disease burden and morbidity compared to adult-onset IBD. Accurate risk prediction for a complicated disease course in childhood onset IBD is essential for making the best treatment choices. Complicating course in IBD is closely linked with choice of therapies and treatment targets. In this review article, we examine risk factors of complicated disease course in children with IBD in the era of increasing use of biologics and tighter treatment targets. We also discuss emerging paediatric data supporting an early intensive approach targeting deeper healing, aiming for remission beyond symptoms with repeat endoscopic examination to make treatment adjustments.
与成人起病的炎症性肠病(IBD)相比,儿童起病的IBD疾病负担和发病率更高。准确预测儿童起病IBD复杂病程的风险对于做出最佳治疗选择至关重要。IBD的复杂病程与治疗方法和治疗目标的选择密切相关。在这篇综述文章中,我们探讨了在生物制剂使用增加和治疗目标更严格的时代,儿童IBD复杂病程的风险因素。我们还讨论了新出现的儿科数据,这些数据支持一种早期强化方法,即针对更深层次的愈合,通过重复内镜检查以超越症状实现缓解,从而进行治疗调整。