Disease phenotypic and outcome of very-early onset inflammatory bowel disease in Asian children: an understudied population
Issued Date
2025-01-01
Resource Type
eISSN
22962360
Scopus ID
2-s2.0-86000106019
Journal Title
Frontiers in Pediatrics
Volume
13
Rights Holder(s)
SCOPUS
Bibliographic Citation
Frontiers in Pediatrics Vol.13 (2025)
Suggested Citation
Lee W.S., Chew K.S., Huang J.G., Tanpowpong P., Mercado K.S.C., Reodica A., Logarajah V., Hathagoda K.L.W., Rajindrajith S., Wong Y.K.Y., Treepongkaruna S., Aw M.M. Disease phenotypic and outcome of very-early onset inflammatory bowel disease in Asian children: an understudied population. Frontiers in Pediatrics Vol.13 (2025). doi:10.3389/fped.2025.1487253 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/106727
Title
Disease phenotypic and outcome of very-early onset inflammatory bowel disease in Asian children: an understudied population
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Abstract
Background: There is a paucity of knowledge on disease phenotype and outcome of very early-onset (VEO) inflammatory bowel disease (VEO-IBD) from recently developed and developing countries, including from Southeast Asia. We studied disease phenotype, clinical characteristics, management and outcome of VEO-IBD in South and Southeast Asian children. Materials and methods: We extracted data from a multicentre Asian pediatric (onset <18 years) IBD registry. VEO- and later-onset pediatric (LO-p) IBD were defined as onset of disease <6 years and ≥6 years, respectively. We excluded monogenic IBD. Results: Of 440 children with IBD cases; 112 (25.5%) were VEO-IBD; Crohn's disease (CD) 36 (32.1%); ulcerative colitis (UC) 68 (60.7%), and IBD-unspecified 7 (7.1%). UC was more common in VEO-IBD while CD more common in LO-pIBD (CD = 68.9% vs. UC = 25.9%; p < 0.001). Disease location/extent of disease and disease severity were similar in both age groups for both CD and UC. For CD, inflammatory disease behavior was equally common in both age group (77.8% in VEO-IBD vs. 76.6% of LO-pIBD), majority had isolated colonic disease (27.8% VEO-IBD vs. 36.3% LO-pIBD), while stricturing and penetrating diseases were not observed in VEO-CD, but noted in 4.9% and 8.4% of LO-pCD, respectively. Among UC cases, pancolitis was observed in 60.3% of VEO-IBD vs. 65.9% of LO-pIBD. Most UC never had severe disease regardless of age group. Five years after diagnosis, VEO-IBD were more likely to have corticosteroids, immunomodulators or biologics than LO-pIBD. Despite this, inactive/mild disease activity was the predominant outcome at 5 year follow up for both VEO-CD (98.2%) and VEO- UC (96.1%). Bowel surgery rate was 2.4% and 1.7% for VEO- and LO-IBD at 5 years, respectively. Conclusions: Despite differences in disease phenotype at diagnosis, disease behaviour, location/extent and disease severity were similar between VEO- and LO-IBD, with a comparable overall clinical remission rates between both age groups at 5 years after diagnosis.