title: Advances in the medical management of paediatric IBD.
abstract: IBD includes two classic entities, Crohn's disease and ulcerative colitis, and a third undetermined form (IBD-U), characterized by a chronic relapsing course resulting in a high rate of morbidity and impaired quality of life. Children with IBD are vulnerable in terms of growth failure, malnutrition and emotional effects. The aims of therapy have now transitioned from symptomatic control to the achievement of mucosal healing and deep remission. This type of therapy has been made possible by the advent of disease-modifying drugs, such as biologic agents, which are capable of interrupting the inflammatory cascade underlying IBD. Biologic agents are generally administered in patients who are refractory to conventional therapies. However, there is growing support that such agents could be used in the initial phases of the disease, typically in paediatric patients, to interrupt and cease the inflammatory process. Until several years ago, most therapeutic programmes in paediatric patients with IBD were borrowed from adult trials, whereas paediatric studies were often retrospective and uncontrolled. However, guidelines on therapeutic management of paediatric IBD and controlled, prospective, randomized trials including children with IBD have now been published. Here, the current knowledge concerning treatment options for children with IBD are reported. We also highlight the effectiveness and safety of new therapeutic advances in these paediatric patients.
authors: Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, Rome 00161, Italy.
authors: Marina
authors: M
authors: Aloi
authors: Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, Rome 00161, Italy.
authors: Federica
authors: F
authors: Nuti
authors: Department of Radiobiology and Human Health, ENEA (National Agency for Energy, New Technologies and Environment), Via Anguillarese 301, Rome 00123, Italy.
authors: Laura
authors: L
authors: Stronati
authors: Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena 324, Rome 00161, Italy.
authors: Salvatore
authors: S
authors: Cucchiara
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001691:Biological Therapy / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000628:therapy; D003424:Crohn Disease / Q000628:therapy; D006801:Humans; D056747:Immunomodulation; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D044623:Nutrition Therapy / Q000639:trends*; D016896:Treatment Outcome