Progress in the treatment and outcome of pediatric inflammatory bowel disease patients

ABSTRACT

Introduction: The number of pediatric patients with inflammatory bowel disease (IBD), namely Crohn´s disease, ulcerative colitis and unclassified colitis, has rapidly increased in Western countries.

Areas covered: This review discusses how the treatment of pediatric IBD patients has improved,with attention given to therapeutic quality and cost. The literature search covers Medline-PubMed and the Cochrane Library, with February 2016 as the last search dates. Similarly to what has been the trend in the management of adult IBD, pediatric IBD therapy has become more active than before. High use of immunosuppressants and the availability of biological therapeutic agents has helped to control the extensive and aggressive course of pediatric IBD. Full disease control at an early phase has advantages such as preserving normal child growth and development, maintaining overall good health and quality of life, as well as decreasing the psychosocial burden of the disease.

Expert commentary: A key research direction is to tailor treatment modalities according to anticipated individual phenotype and disease course. Another is to reduce healthcare costs by decreasing the so-far high rate of surgery of pediatric IBD patients, and, instead, to develop a more active approach to treatment than before.

KEYWORDS:

• Calprotectin
• children
• colitis ulcerative
• cost of care
• Crohn´s disease
• fecal markers
• growth
• management

Declaration of interest

The work was supported by the Finnish Foundation for Pediatric Research, by the Helsinki University Central Hospital Research Fund (TYH2013321), the Sigrid Jusélius Foundation. The Foundations providing grants had no role in the study design, the collection, analysis and interpretation of the data, writing the report or the decision to submit the paper. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by the Helsingin ja Uudenmaan Sairaanhoitopiiri: [Grant Number TYH2013321]; Sigrid Jusélius Foundation and Pediatric Research Foundation [Grant Number not numbered].