{Reference Type}: Journal Article
{Title}: The need for surgery in pediatric patients with inflammatory bowel disease treated with biologicals.
{Author}: Kolho KL;Nikkonen A;Merras-Salmio L;Molander P;
{Journal}: Int J Colorectal Dis
{Volume}: 39
{Issue}: 1
{Year}: 2024 Apr 25
{Factor}: 2.796
{DOI}: 10.1007/s00384-024-04634-7
{Abstract}: <B>OBJECTIVE: </B>Inflammatory bowel disease (IBD) in childhood often presents with a more extensive and more aggressive disease course than adult-onset disease. We aimed to evaluate if biological treatment started in childhood decreases the need for intestinal surgery over time.<BR><B>METHODS: </B>This was a retrospective, single-center, cohort study. All pediatric patients with IBD initiated to biological therapy at the Children's Hospital, were included in the study and followed up to the first surgical procedure or re-operation in their adulthood or until 31.12.2021 when ≥ 18 of age. Data were collected from the pediatric registry of IBD patients with biologicals and medical charts.<BR><B>RESULTS: </B>A total of 207 pediatric IBD patients were identified [150 with Crohn´s disease (CD), 31 with ulcerative colitis (UC), 26 with IBD unclassified (IBDU)] of which 32.9% (n = 68; CD 49, UC 13, IBDU 6) underwent intestinal surgery. At the end of a median follow-up of 9.0 years (range 2.0-25.9), patients reached a median age of 21.4 years (range 18-36). Patients who had intestinal surgery in childhood were more likely to have IBD-related surgery also in early adulthood. The duration of the disease at induction of the first biological treatment emerged as the only risk factor, with a longer duration in the surgical group than in patients with no surgery.<BR><B>CONCLUSIONS: </B>Despite initiation of biological treatment, the risk of intestinal surgery remains high in pediatric IBD patients and often the need for surgery emerges after the transition to adult IBD clinics.