Medical Faculty Carl Gustav Carus, Institute for Medical Informatics and Biometry, TU Dresden, Fetscherstrasse 74, Dresden, 01307, Germany.
Medical Faculty Carl Gustav Carus Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, TU Dresden, Fetscherstrasse 74, Dresden, 01307, Germany.
Eur J Pediatr. 2024 Oct;183(10):4363-4377. doi: 10.1007/s00431-024-05671-8. Epub 2024 Aug 3.
The escalating worldwide prevalence of Crohn's disease (CD) among children and adolescents, coupled with a trend toward earlier onset, presents significant challenges for healthcare systems. Moreover, the chronicity of this condition imposes substantial individual burdens. Consequently, the principal objective of CD treatment revolves around rapid inducing remission. This study scrutinizes the impact of age, gender, initial disease localization, and therapy on the duration to achieve disease activity amelioration. Data from the Saxon Pediatric IBD Registry in Germany were analyzed over a period of 15 years. In addition to descriptive methods, logistic and linear regression analyses were conducted to identify correlations. Furthermore, survival analyses and Cox regressions were utilized to identify factors influencing the time to improvement in disease activity. These effects were expressed as Hazard Ratios (HR) with 95% confidence intervals. Data on the clinical course of 338 children and adolescents with CD were available in the registry. The analyses showed a significant correlation between a young age of onset and the severity of disease activity. It was evident that treatment with anti-TNF (Infliximab) was associated with a more favorable prognosis in terms of the time required for improvement in disease activity. Similarly, favorable outcomes were observed with the combination therapies of infliximab with enteral nutrition therapy and Infliximab with immunosuppressants.Conclusion: Our analysis of data from the Saxon Pediatric IBD Registry revealed that the timeframe for improvement of disease activity in pediatric Crohn's disease is influenced by several factors. Specifically, patient age, treatment modality, and initial site of inflammation were found to be significant factors. The study provides important findings that underline the need for individualized treatment.
全球儿童和青少年克罗恩病（CD）的患病率不断上升，且发病年龄有提前的趋势，这给医疗保健系统带来了巨大的挑战。此外，这种疾病的慢性特征给个人带来了巨大的负担。因此，CD 治疗的主要目标是迅速诱导缓解。本研究探讨了年龄、性别、初始疾病定位和治疗对达到疾病活动改善所需时间的影响。德国萨克森儿科 IBD 注册中心的 15 年数据进行了分析。除了描述性方法外，还进行了逻辑和线性回归分析以确定相关性。此外，还进行了生存分析和 Cox 回归以确定影响疾病活动改善时间的因素。这些影响以具有 95%置信区间的危害比（HR）表示。注册中心有 338 名儿童和青少年 CD 临床病程的数据。分析表明，发病年龄越小，疾病活动的严重程度越高。抗 TNF（英夫利昔单抗）治疗与改善疾病活动所需时间的预后更有利相关。同样，英夫利昔单抗联合肠内营养治疗和英夫利昔单抗联合免疫抑制剂的联合治疗也观察到了良好的结果。结论：我们对萨克森儿科 IBD 注册中心数据的分析表明，儿科克罗恩病疾病活动改善的时间框架受多种因素的影响。具体来说，患者年龄、治疗方式和初始炎症部位是重要的影响因素。该研究提供了重要的发现，强调了个体化治疗的必要性。
