The incidence of Crohn’s disease has been reported to increase.
Dr Dana Duricova and colleagues performed a comprehensive literature search of population-based studies focused on the natural history of pediatric-onset Crohn’s disease.
The researchers performed a literature search of English and non-English language publications listed in the electronic database of MEDLINE, and EMBASE from 1935 to 2016.
Population-based studies or national cohorts reporting data on the short-term or long-term disease course of pediatric Crohn’s disease were included.
The research team identified 49 pediatric, and 15 nonpediatric studies on Crohn’s disease.
About 33% of children with inflammatory behavior developed bowel complications more than 5 years after diagnosis.
|More than 33% of children have received biological treatment early in the disease course|
|European Journal of Gastroenterology & Hepatology|
The team observed that from 48% to 88% of children have experienced at least one corticosteroid course irrespective of the period of diagnosis, and up to 33% became steroid dependent.
The researchers found that immunosuppressive preparations were used earlier, and more frequently in newer than older cohorts.
The team noted that more than 33% of children have received biological treatment early in the disease course.
A decline in the surgery rate might be observed in more recent compared with older unselected populations.
The team found that the relative risk of cancer in childhood-onset Crohn’s disease as well as the risk of death seem to have increased.
Dr Duricova's team concludes, "Childhood-onset Crohn’s disease seems to be an aggressive phenotype of the disease."
"Compared with older cohorts, a trend towards decreasing surgical rate can be observed in newer cohorts paralleled by an increase in immunomodulator use and biologicals."
"Nevertheless, the causative role has yet to be investigated."