Outcome following aminosalicylate therapy in children newly diagnosed as having ulcerative colitis

Bella Zeisler, Trudy Lerer, James Markowitz, David MacK, Anne Griffiths, Athos Bousvaros, David Keljo, Joel Rosh, Jonathan Evans, Michael Kappelman, Anthony Otley, Marsha Kay, Andrew Grossman, Shehzad Saeed, Ryan Carvalho, Maria Oliva-Hemker, William Faubion, Boris Sudel, Marian Pfefferkorn, Farhat Ashai-KhanNeal Leleiko, Jeffrey Hyams

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

OBJECTIVES: Despite a paucity of published supporting data, 5-aminosalicylate (5-ASA) use in pediatric ulcerative colitis (UC) is common. The present study describes the use and outcome of a large multicenter inception cohort of children with UC treated with 5-ASA. METHODS: Data were obtained from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry, a prospective North American observational study of children newly diagnosed as having inflammatory bowel disease ages 16 years or younger. Patient data are recorded at diagnosis, 30 days, and then quarterly. Patients are managed by physician dictate, not protocol. Disease activity is classified by physician global assessment. The primary outcome examined was corticosteroid (CS) free, inactive UC at 1 year following initiation of 5-ASA within 30 days of diagnosis (with or without concomitant CS use) without the need for rescue therapy (immunomodulators, biologics, or colectomy). RESULTS: Study subjects included 213 patients newly diagnosed as having UC who received oral 5-ASA compounds (115 of whom also received CS) during the first 30 days after diagnosis, and no other oral therapies for the treatment of UC. Of these 213 patients, 86 (40%) were CS free and physician global assessment inactive at 1 year without rescue. Outcome was not associated with disease severity at diagnosis, demographic or laboratory factors examined, or initial dose of 5-ASA used. CONCLUSIONS: Forty percent of children taking 5-ASA as primary maintenance therapy at diagnosis are in CS-free remission after 1 year of treatment. Further pediatric studies will be needed to address whether increased adherence and/or higher dosing schedules will improve outcomes.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalJournal of pediatric gastroenterology and nutrition
Volume56
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • 5-aminosalicylate
  • children
  • ulcerative colitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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