Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study

Background Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited. Purpose Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian c...

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Main Authors: Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw
Format: Article
Language:English
Published: The Korean Pediatric Society 2025-03-01
Series:Clinical and Experimental Pediatrics
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Online Access:http://e-cep.org/upload/pdf/cep-2024-01144.pdf
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author Pornthep Tanpowpong
Suporn Treepongkaruna
James Guoxian Huang
Kee Seang Chew
Karen Sophia Calixto Mercado
Almida Reodica
Shaman Rajindrajith
Wathsala Hathagoda
Yoko Kin Yoke Wong
Way Seah Lee
Marion Margaret Aw
author_facet Pornthep Tanpowpong
Suporn Treepongkaruna
James Guoxian Huang
Kee Seang Chew
Karen Sophia Calixto Mercado
Almida Reodica
Shaman Rajindrajith
Wathsala Hathagoda
Yoko Kin Yoke Wong
Way Seah Lee
Marion Margaret Aw
author_sort Pornthep Tanpowpong
collection DOAJ
description Background Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited. Purpose Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children. Methods The multinational network included patients with PIBD (aged <19 years) in 5 Asian countries (Malaysia, Philippines, Singapore, Sri Lanka, and Thailand). The diagnosis of PIBD requires gastrointestinal endoscopy. The patients' demographics, clinical information, disease- related outcomes, and treatment data at 1FU were collected. Results In 1995–2021, 368 patients were enrolled (Crohn disease [CD], 56.8%; ulcerative colitis [UC], 38%; and inflammatory bowel disease [IBD]-unclassified, 5.2%). At 1FU, symptoms including diarrhea, bloody stools, and nausea/vomiting subsided in <3%, while abdominal pain persisted in 10.5% of patients with CD and 7.1% of patients with UC. Assessment endoscopy was performed at 1FU in 38% of CD and 31% of UC cases, of which 21% and 23% showed mucosal healing, respectively. Oral prednisolone was administered to 55.3% of patients at diagnosis and 26.8% at 1FU, while infliximab was administered to 2.5% and 7.2% of patients at diagnosis and 1FU, respectively. Independent factors of 1-year clinical remission for CD were oral prednisolone (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06–0.68), antibiotic use (OR, 0.09; 95% CI, 0.01–0.54), and immunomodulator use (OR, 5.26; 95% CI, 1.52–18.22). A history of weight loss at diagnosis was the only independent risk factor of an IBD flare by 1FU (OR, 2.01; 95% CI, 1.12–3.63). Conclusion The proportion of children with PIBD and abdominal pain at 1FU remained high. The rates of repeat endoscopy and infliximab use were suboptimal with high rates of systemic corticosteroid use. Quality improvement based on the aforementioned predictors may enhance PIBD care in this geographic region or similar settings.
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spelling doaj-art-c0e33a3c7ee649599c7cf30ac4cb07c42025-08-20T02:15:30ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482025-03-0168324725610.3345/cep.2024.0114420125555759Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up studyPornthep Tanpowpong0Suporn Treepongkaruna1James Guoxian Huang2Kee Seang Chew3Karen Sophia Calixto Mercado4Almida Reodica5Shaman Rajindrajith6Wathsala Hathagoda7Yoko Kin Yoke Wong8Way Seah Lee9Marion Margaret Aw10 Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Department of Pediatrics, Makati Medical Center, Manila, the Philippines Department of Pediatrics, The Medical City, Manila, the Philippines Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka Epidemiology, Singapore Clinical Research Institute, Singapore, Singapore Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, SingaporeBackground Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited. Purpose Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children. Methods The multinational network included patients with PIBD (aged <19 years) in 5 Asian countries (Malaysia, Philippines, Singapore, Sri Lanka, and Thailand). The diagnosis of PIBD requires gastrointestinal endoscopy. The patients' demographics, clinical information, disease- related outcomes, and treatment data at 1FU were collected. Results In 1995–2021, 368 patients were enrolled (Crohn disease [CD], 56.8%; ulcerative colitis [UC], 38%; and inflammatory bowel disease [IBD]-unclassified, 5.2%). At 1FU, symptoms including diarrhea, bloody stools, and nausea/vomiting subsided in <3%, while abdominal pain persisted in 10.5% of patients with CD and 7.1% of patients with UC. Assessment endoscopy was performed at 1FU in 38% of CD and 31% of UC cases, of which 21% and 23% showed mucosal healing, respectively. Oral prednisolone was administered to 55.3% of patients at diagnosis and 26.8% at 1FU, while infliximab was administered to 2.5% and 7.2% of patients at diagnosis and 1FU, respectively. Independent factors of 1-year clinical remission for CD were oral prednisolone (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06–0.68), antibiotic use (OR, 0.09; 95% CI, 0.01–0.54), and immunomodulator use (OR, 5.26; 95% CI, 1.52–18.22). A history of weight loss at diagnosis was the only independent risk factor of an IBD flare by 1FU (OR, 2.01; 95% CI, 1.12–3.63). Conclusion The proportion of children with PIBD and abdominal pain at 1FU remained high. The rates of repeat endoscopy and infliximab use were suboptimal with high rates of systemic corticosteroid use. Quality improvement based on the aforementioned predictors may enhance PIBD care in this geographic region or similar settings.http://e-cep.org/upload/pdf/cep-2024-01144.pdfbloody stoolsendoscopyflaremucosal healingsteroids
spellingShingle Pornthep Tanpowpong
Suporn Treepongkaruna
James Guoxian Huang
Kee Seang Chew
Karen Sophia Calixto Mercado
Almida Reodica
Shaman Rajindrajith
Wathsala Hathagoda
Yoko Kin Yoke Wong
Way Seah Lee
Marion Margaret Aw
Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
Clinical and Experimental Pediatrics
bloody stools
endoscopy
flare
mucosal healing
steroids
title Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
title_full Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
title_fullStr Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
title_full_unstemmed Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
title_short Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
title_sort outcome of pediatric inflammatory bowel disease in asian children a multinational 1 year follow up study
topic bloody stools
endoscopy
flare
mucosal healing
steroids
url http://e-cep.org/upload/pdf/cep-2024-01144.pdf
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