title: Differences in phenotype and disease course in adult and paediatric inflammatory bowel disease--a population-based study.
abstract: BACKGROUND
  Few studies have compared phenotype and disease course in children and adults with inflammatory bowel disease (IBD).
  
  
  OBJECTIVE
  To compare phenotype, treatment and disease course in children (<15 years) and adults (≥18 years) with IBD.
  
  
  METHODS
  Two population-based cohorts comprising paediatric (2001-2006) and adult (2003-2004) patients from Copenhagen County and City were studied.
  
  
  RESULTS
  Twenty children and 106 adults with ulcerative colitis (UC), and 29 children and 67 adults with Crohn's disease (CD) were included. Median follow-up time was 4.8 years (children) and 5.2 years (adults). Children with UC had more extensive disease compared to adult patients [14 (70%) vs. 20 (19%), P<0.001]. The risks of starting systemic steroid treatment and AZA/MP were higher for paediatric UC patients compared to adult UC patients; hazard ratio (HR): 3.1 (95% CI: 1.8-5.3) and HR: 2.5 (1.3-5-9), respectively. Steroid dependency was more frequent in paediatric than in adult UC patients [9 (45%) vs. 9 (8%), P<0.001]. Mild disease course was less frequent in children with UC compared to adult patients [7 (35%) vs. 76 (72%), P=0.002]. Paediatric and adult CD patients did not differ regarding treatment or disease course. Cumulative 5-year surgery rates for paediatric and adult patients were 5% and 9% for UC (N.S.) and 18% and 21% for CD (N.S.), respectively.
  
  
  CONCLUSIONS
  Paediatric UC patients had more extensive disease, were more often treated with systemic steroids and AZA, had a higher frequency of steroid dependency and a more severe disease course compared to adult UC patients. No differences were found when comparing paediatric and adult CD patients.
authors: Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark. christian.jakobsen@hvh.regionh.dk
authors: C
authors: C
authors: Jakobsen
authors: J
authors: J
authors: Bartek
authors: V
authors: V
authors: Wewer
authors: I
authors: I
authors: Vind
authors: P
authors: P
authors: Munkholm
authors: R
authors: R
authors: Groen
authors: A
authors: A
authors: Paerregaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D003424:Crohn Disease / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D003718:Denmark; D013505:Digestive System Surgical Procedures; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D010641:Phenotype
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D007155:Immunologic Factors; D000069285:Infliximab