Identification of predictive factors of AZA/6-MP treatment outcome in peadiatric Crohn's disease
Authors:
T. Dršková; O. Hradský; J. Bronský
Authors‘ workplace:
Pediatrická klinika 2. LF UK a FN Motol, Praha
Published in:
Čes-slov Pediat 2017; 72 (5): 282-289.
Category:
Overview
Crohn's disease (CD) and ulcerative colitis (UC) are forms of inflamatory bowel disease (IBD). IBD is a group of chronic diseases causing disability and requiring repeated hospitalizations, with worldwide increasing incidence.
Treatment of peadiatric CD usually consists of two basic steps. The first is induction of remission, which is subsequently followed by long-term immunosuppressive therapy – which are, based on recent recommendations, thiopurines. According to previous studies aproximatelly 50% of patients relapse within two years of starting the thiopurine treatment and require a change in the therapeutic process. According to data from the adult population the long-term prognosis of the disease is significently influenced by progression of inflammation or development of complications. Early initiation of an intensive therapeutic regime could prevent the progression of inflammation and the development of complications and thus, if applied correctly, influence the long-term prognosis of the disease. The possibility of early failure prediction, allowing the selection of a group of high risk patients primarily chosen for different therapeutic approach, is with current level of knowledge non-satisfactory in both peadiatric and adult populations.
Key words:
inflamatory bowel disease, IBD, Crohn's disease, thiopurines, relapse, complication, prediction, predictor
Sources
1. Benchimol EI, Fortinsky KJ, Gozdyra P, et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis 2011; 17: 423–439.
2. Burisch J. Crohn‘s disease and ulcerative colitis. Occurrence, course and prognosis during the first year of disease in a European population-based inception cohort. Dan Med J 2014; 61: B4778.
3. Burisch J, Jess T, Martinato M, et al. The burden of inflammatory bowel disease in Europe. J Crohns Colitis 2013; 7: 322–337.
4. Kalla R, Kennedy NA, Ventham NT, et al. Serum Calprotectin: A novel diagnostic and prognostic marker in inflammatory bowel diseases. Am J Gastroenterol 2016; 111: 1796–1805.
5. Lund JL, Cook SF, Allen JK, et al. Patterns of 6-mercaptopurine and azathioprine maintenance therapy among a cohort of commercially insured individuals diagnosed with Crohn‘s disease in the United States. Clinical Epidemiology 2013; 5: 501–512.
6. Mason A, Malik S, McMillan M, et al. A Prospective longitudinal study of growth and pubertal progress in adolescents with inflammatory bowel disease. Horm Res Paediatr 2014; 83: 45–54.
7. Cardile S, Alterio T, Candusso M, et al. Autoimmune liver diseases and inflammatory bowel diseases in children: current issues and future perspectives. Scand J Gastroenterol 2017; 52: 662–667.
8. Greuter T, Bertoldo F, Rechner R, et al. Extraintestinal manifestations of pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2017 Aug: 65 (2): 200–206.
9. Torres J, Caprioli F, Katsanos KH, et al. Predicting outcomes to optimize disease management in inflammatory bowel diseases. J Crohns Colitis 2016; 371: 660–667.
10. Pariente B, Cosnes J, Danese S, et al. Development of the Crohn‘s disease digestive damage score, the Lémann score. Inflamm Bowel Dis 2011; 17: 1415–1422.
11. Ruemmele FM, Veres G, Kolho KL, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn‘s disease. J Crohns Colitis 2014; 8: 1179–1207.
12. Levine A, Koletzko S, Turner D, et al. The ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2013; 58: 1.
13. Riello L, Talbotec C, Garnier-Lengliné H, et al. Tolerance and efficacy of azathioprine in pediatric Crohn‘s disease. Inflamm Bowel Dis 2011; 17: 2138–2143.
14. Hradsky O, Copova I, Zarubova K, et al. Time to relapse in children with Crohn‘s disease treated with Azathioprine and nutritional therapy or corticosteroids. Dig Dis Sci 2016: 61 (7): 2041–2050.
15. Markowitz J, Grancher K, Kohn N, et al. Alimentary tract. A multicenter trial of 6-mercaptopurine and prednisone in children with newly diagnosed Crohn‘s disease. Materials and methods. Gastroenterology 2000; 119: 895–902.
16. Punati J, Markowitz J, Lerer T, et al. Effect of early immunomodulator use in moderate to severe pediatric Crohn disease. Inflamm Bowel Dis 2008; 14: 949–954.
17. Jaspers GJ, Verkade HJ, Escher JC, et al. Azathioprine maintains first remission in newly diagnosed pediatric Crohn‘s disease. Inflamm Bowel Dis 2006; 12: 831–836.
18. D‘Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn‘s disease: an open randomised trial. Lancet 2008; 371: 660–667.
19. Peyrin-Biroulet L, Bigard MA, Malesci A, et al. Step-up and top-down approaches to the treatment of Crohn‘s disease: early may already be too late. Gastroenterology 2008; 135: 1420–1422.
20. Chaparro M, Panes J, García V, et al. Long-term durability of infliximab treatment in Crohn‘s disease and efficacy of dose „escalation“ in patients losing response. J Clin Gastroenterol 2011; 45: 113–118.
21. Ruemmele FM, Lachaux A, Cézard J-P, et al. Efficacy of infliximab in pediatric Crohn‘s disease: a randomized multicenter open-label trial comparing scheduled to on demand maintenance therapy. Inflamm Bowel Dis 2009; 15: 388–394.
22. Bonovas S, Fiorino G, Allocca M, et al. Biologic therapies and risk of infection and malignancy in patients with inflammatory bowel disease: A systematic review and network meta-analysis. Clin Gastroenterol Hepatol 2016; 14: 1385–1397.
23. de Bie CI, Escher JC, de Ridder L. Antitumor necrosis factor treatment for pediatric inflammatory bowel disease. Inflamm Bowel Dis 2012; 18: 985–1002.
24. Hindorf U, Lindqvist M, Hildebrand H, et al. Adverse events leading to modification of therapy in a large cohort of patients with inflammatory bowel disease. Aliment Pharmacol Ther 2006; 24: 331–342.
25. Gearry RB, Barclay ML, Burt MJ, et al. Thiopurine drug adverse effects in a population of New Zealand patients with inflammatory bowel disease. Pharmacoepidemiol Drug Saf 2004; 13: 563–567.
26. Beaugerie L, Brousse N, Bouvier AM, et al. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet (London, England) 2009; 374: 1617–1625.
27. Kandiel A, Fraser AG, Korelitz BI, et al. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut 2005; 54: 1121–1125.
28. Magro F, Peyrin-Biroulet L, Sokol H, et al. Extra-intestinal malignancies in inflammatory bowel disease: Results of the 3rd ECCO Pathogenesis Scientific Workshop (III). J Crohns Colitis 2014; 8: 31–44.
29. Beaugerie L, Seksik P, Nion-Larmurier I, et al. Predictors of Crohn‘s disease. Gastroenterology 2006; 130: 650–656.
30. Cosnes J, Bourrier A, Nion-Larmurier I, et al. Factors affecting outcomes in Crohn‘s disease over 15 years. Gut 2012; 61: 1140–1145.
31. Romberg-Camps MJL, Dagnelie PC, Kester ADM, et al. Influence of phenotype at diagnosis and of other potential prognostic factors on the course of inflammatory bowel disease. Am J Gastroenterol 2009; 104: 371–383.
32. Thia KT, Sandborn WJ, Harmsen WS, et al. Risk factors associated with progression to intestinal complications of Crohn‘s disease in a population-based cohort. Gastroenterology 2010; 139: 1147–1155.
33. Targan SR, Landers CJ, Yang H, et al. Antibodies to CBir1 flagellin define a unique response that is associated independently with complicated Crohn‘s disease. Gastroenterology 2005; 128: 2020–2028.
34. Abreu MT, Taylor KD, Lin Y-C, et al. Mutations in NOD2 are associated with fibrostenosing disease in patients with Crohn‘s disease. Gastroenterology 2002; 123: 679–688.
35. Louis E, Michel V, Hugot JP, et al. Early development of stricturing or penetrating pattern in Crohn‘s disease is influenced by disease location, number of flares, and smoking but not by NOD2/CARD15 genotype. Gut 2003; 52: 552–557.
36. Alvarez-Lobos M, Arostegui JI, Sans M, et al. Crohn‘s disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence. Ann Surg 2005; 242: 693–700.
37. Tarrant KM, Barclay ML, Frampton CMA, et al. Perianal disease predicts changes in Crohn‘s disease phenotype-results of a population-based study of inflammatory bowel disease phenotype. Am J Gastroenterol 2008; 103: 3082–3093.
38. Lakatos PL, Czegledi Z, Szamosi T, et al. Perianal disease, small bowel disease, smoking, prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn‘s disease. World J Gastroenterol 2009; 15: 3504–3510.
39. Siegel CA, Siegel LS, Hyams JS, et al. Real-time tool to display the predicted disease course and treatment response for children with Crohn‘s disease. Inflamm Bowel Dis 2011; 17: 30–38.
40. Henderson P, Kennedy NA, Van Limbergen JE, et al. Serum C-reactive protein and CRP genotype in pediatric inflammatory bowel disease: influence on phenotype, natural history, and response to therapy. Inflamm Bowel Dis 2015; 21: 596–605.
41. Levine A, Turner D, Pfeffer Gik T, et al. Comparison of outcomes parameters for induction of remission in new onset pediatric Crohn‘s disease: evaluation of the porto IBD group "growth relapse and outcomes with therapy" (GROWTH CD) study. Inflamm Bowel Dis 2014; 20: 278–285.
42. Dubinsky MC, Kugathasan S, Mei L, et al. Increased immune reactivity predicts aggressive complicating Crohn‘s disease in children. Clin Gastroenterol Hepatol 2008; 6: 1105–1111.
43. Desir B, Amre DK, Lu S-E, et al. Utility of serum antibodies in determining clinical course in pediatric Crohn‘s disease. Clin Gastroenterol Hepatol 2004; 2: 139–146.
44. Gupta N, Cohen SA, Bostrom AG, et al. Risk factors for initial surgery in pediatric patients with Crohn’s disease. Gastroenterology 2006; 130: 1069–1077.
45. Fabian O, Hradsky O, Potuznikova K, et al. Low predictive value of histopathological scoring system for complications development in children with Crohn‘s disease. Pathol Res Pract 2017; 213: 353–358.
46. Fraser AG, Orchard TR, Jewell DP. The efficacy of azathioprine for the treatment of inflammatory bowel disease: a 30 year review. Gut 2002; 50: 485–489.
47. Koifman E, Karban A, Mazor Y, et al. Thiopurine effectiveness in patients with Crohn‘s disease: a study of genetic and clinical predictive factors. Inflamm Bowel Dis 2013; 19: 1639–1644.
48. Gevers D, Kugathasan S, Denson Lee A, et al. The treatment-naive microbiome in new-onset Crohn’s disease. Cell Host & Microbe 2014; 15: 382–392.
49. Cleynen I, Boucher G, Jostins L, et al. Inherited determinants of Crohn‘s disease and ulcerative colitis phenotypes: a genetic association study. Lancet 2016; 387: 156–167.
50. Hammer HB, Odegard S, Syversen SW, et al. Calprotectin (a major S100 leucocyte protein) predicts 10-year radiographic progression in patients with rheumatoid arthritis. Ann Rheum Dis 2010; 69: 150–154.
51. Reid PA, McAllister DA, Boyd AC, et al. Measurement of serum calprotectin in stable patients predicts exacerbation and lung function decline in cystic fibrosis. Am J Respir Crit Care Med 2015; 191: 233–236.
52. Gray RD, Imrie M, Boyd AC, et al. Sputum and serum calprotectin are useful biomarkers during CF exacerbation. J Cyst Fibros 2010; 9: 193–198.
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2017 Issue 5
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