Journal of pediatric gastroenterology and nutrition · 2026
Long-term outcomes of children with ulcerative colitis after acute severe colitis: A GETAID pédiatrique multicenter study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Cochet Manon, Beauvais Agathe, Ruemmele Frank, Enaud Raphael, Lamireau Thierry, Duclaux-Loras Rémi, Dupont Claire, Willot Stéphanie, Bridoux-Henno Laure, Dimitrov Georges, Lemale Julie, Guinard-Samuel Vincent, Bertrand Valérie, Breton Anne, Vinson Christine Martinez, Coopman Stéphanie, Ley Delphine, Pigneur Bénédicte, and the Groupe d'Etudes Thérapeutiques des Affections Inflammatoires du tube Digestif (GETAID) pédiatrique
Аннотация
OBJECTIVES: Acute severe colitis (ASC) is a frequent and severe complication of ulcerative colitis (UC) with a high risk of colectomy. Effects of immunosuppressants and anti-tumor necrosis factor (anti-TNF) agents on the risk of colectomy remain debated. We wished to study the evolution of French pediatric-onset UC patients after ASC.
METHODS: This retrospective study was conducted in 12 French centers of the GETAID pédiatrique group. Data on patients with UC aged <18 years admitted with ASC (defined as Pediatric Ulcerative Colitis Activity Index [PUCAI] score ≥ 65) between January 2010 and December 2020 were collected at discharge and at 1, 3, and 5 years after admission. The primary outcome was colectomy-free rates at 1 year. Uni- and multivariate analyses were performed to identify prognostic factors associated with the risk of surgery.
RESULTS: Of the 102 patients admitted with ASC, 95 (93%) were treated with corticosteroids. Forty-eight (50%) patients were escalated to second-line therapy, mainly to infliximab. Nine patients (8.8%) underwent colectomy before discharge. Colectomy-free survival rates were 82% at 1 year, 76% at 3 years, and 74% at 5 years. Patients without colectomy were in clinical and biological remission for a long time. In multivariate analysis, new onset UC, treatment with azathioprine or anti-TNF agent, were significantly associated with a lower risk of colectomy.
CONCLUSIONS: The rate of colectomy decreases but remains high after an episode of acute colitis despite early use of biotherapies. But long-term outcome of pediatric-onset UC patients seems good with sustained clinical and biological remission.
METHODS: This retrospective study was conducted in 12 French centers of the GETAID pédiatrique group. Data on patients with UC aged <18 years admitted with ASC (defined as Pediatric Ulcerative Colitis Activity Index [PUCAI] score ≥ 65) between January 2010 and December 2020 were collected at discharge and at 1, 3, and 5 years after admission. The primary outcome was colectomy-free rates at 1 year. Uni- and multivariate analyses were performed to identify prognostic factors associated with the risk of surgery.
RESULTS: Of the 102 patients admitted with ASC, 95 (93%) were treated with corticosteroids. Forty-eight (50%) patients were escalated to second-line therapy, mainly to infliximab. Nine patients (8.8%) underwent colectomy before discharge. Colectomy-free survival rates were 82% at 1 year, 76% at 3 years, and 74% at 5 years. Patients without colectomy were in clinical and biological remission for a long time. In multivariate analysis, new onset UC, treatment with azathioprine or anti-TNF agent, were significantly associated with a lower risk of colectomy.
CONCLUSIONS: The rate of colectomy decreases but remains high after an episode of acute colitis despite early use of biotherapies. But long-term outcome of pediatric-onset UC patients seems good with sustained clinical and biological remission.