Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

Esther Orlanski-Meyer; Martine Aardoom; Amanda Ricciuto; Dan Navon; Nicholas Carman; Marina Aloi; Jiri Bronsky; Jan Däbritz; Marla Dubinsky; Séamus Hussey; Peter Lewindon; Javier Martin De Carpi; Víctor Manuel Navas-López; Marina Orsi; Frank M. Ruemmele; Richard K. Russell; Gabor Veres; Thomas D. Walters; David C. Wilson; Thomas Kaiser; Lissy de Ridder; Anne Griffiths; Dan Turner

doi:10.1053/j.gastro.2020.07.066

Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

Esther Orlanski-Meyer, Martine Aardoom, Amanda Ricciuto, Dan Navon, Nicholas Carman, Marina Aloi, Jiri Bronsky, Jan Däbritz, Marla Dubinsky, Séamus Hussey, Peter Lewindon, Javier Martin De Carpi, Víctor Manuel Navas-López, Marina Orsi, Frank M. Ruemmele, Richard K. Russell, Gabor Veres, Thomas D. Walters, David C. Wilson, Thomas KaiserLissy de Ridder, Anne Griffiths, Dan Turner^*

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background & Aims: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms. Methods: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC. A systematic review of the literature, with selected meta-analysis, was performed to identify studies that investigated predictors for these outcomes. Multiple national and international meetings were held to reach consensus on evidence-based statements. Results: Consensus was reached on 31 statements regarding predictors of colectomy, acute severe colitis (ASC), chronically active pediatric UC, cancer and mortality. At diagnosis, disease extent (6 studies, N = 627; P =.035), Pediatric Ulcerative Colitis Activity Index score (4 studies, n = 318; P <.001), hemoglobin, hematocrit, and albumin may predict colectomy. In addition, family history of UC (2 studies, n = 557; P =.0004), extraintestinal manifestations (4 studies, n = 526; P =.048), and disease extension over time may predict colectomy, whereas primary sclerosing cholangitis (PSC) may be protective. Acute severe colitis may be predicted by disease severity at onset and hypoalbuminemia. Higher Pediatric Ulcerative Colitis Activity Index score and C-reactive protein on days 3 and 5 of hospital admission predict failure of intravenous steroids. Risk factors for malignancy included concomitant diagnosis of primary sclerosing cholangitis, longstanding colitis (>10 years), male sex, and younger age at diagnosis. Conclusions: These evidence-based consensus statements offer predictions to be considered for a personalized medicine approach in treating pediatric UC.

Original language	American English
Pages (from-to)	378-402.e22
Journal	Gastroenterology
Volume	160
Issue number	1
DOIs	https://doi.org/10.1053/j.gastro.2020.07.066
State	Published - Jan 2021

Bibliographical note

Funding Information:
Conflicts of interest These authors disclose the following: Esther Orlanski Meyer and Martine Aardoom have received a consultant fee from AbbVie . Dan Navon is employed by Antelliq Innovation Center, a subsidiary of Merck Sharp & Dohme. Nicholas Carman has received a consultant fee, speaker’s fee, and travel support from AbbVie. Marina Aloi has received a consultation fee, research grant, royalties, or honorarium from AbbVie. Jiri Bronsky has received consultation fee/honoraria/congress support from AbbVie, Merck Sharp & Dohme, Nutricia, Nestlé, and Biocodex. Jan Däbritz has received consultation fees, research grants, royalties, or honoraria from AbbVie, Shire/Takeda, Humana, Nestlé, Ferring, Amgen, Nutricia, and GlaxoSmithKline. Marla Dubinsky is a consultant for AbbVie , Amgen , Arena, Boehringer Ingelheim , Celgene , Eli Lilly , Genentech , Gilead , Janssen, Pfizer , Merck , Prometheus Labs, Projections Research, Rebiotix, and Takeda and has received grant support from AbbVie , Pfizer , and Prometheus Labs. Séamus Hussey has received a consultation fee or honorarium from AbbVie. Peter Lewindon has received speaker fees from AbbVie , Janssen, and Pfizer . Javier Martín de Carpi has received a consultation fee, research grant, royalties, or honorarium from AbbVie, Abbott, Celgene, Celltrion, Dr. Falk, Foundation for Advanced Education in the Sciences, Ferring, Janssen, Lilly, Merck Sharp & Dohme, Nestlé Health Science, Nutricia, and Roche. Víctor Manuel Navas-López has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, AbbVie, Takeda, and Nestlé. Marina Orsi has received a consultation fee, honoraria fee, or travel support from AbbVie, Nutricia-Danone, Mead Johnson, and Ferring. Frank Ruemmele has received speaker fees from Nestlé, Mead Johnson , Ferring , Merck Sharp & Dohme , Johnson & Johnson , Centocor, and AbbVie; serves as a board member for Johnson & Johnson; and has been invited to Merck Sharp & Dohme France, Nestlé Nutrition Institute, Nestlé Health Science, Danone , Mead Johnson , Takeda , Celgene , BioGene, and Arkopharma. Richard K. Russell is supported by a National Health Service Research Scotland Senior Research Fellowship and has received speaker’s fees, travel support, and/or participated in medical board meetings with Nestlé, AbbVie, Dr Falk, Takeda, Napp, Mead Johnson, Nutricia, and 4D Pharma. Gabor Veres has received consultation fees from Nestlé, Danone, and AbbVie. Thomas D. Walters has received a consultation fee, research grant, royalties, or honorarium from Janssen, Merck, AbbVie, Takeda, Nestlé, and Ferring. David C. Wilson has received a consultation fee, research grant, speaker fee, or conference support from 4D Pharma, AbbVie, Falk, Ferring, Napp, Nestlé, Predictimmune, and Roche. Lissy de Ridder has received a grant from or had collaborations (such as industry-sponsored studies, investigator-initiated studies, and consultancy) with Shire , Mallinckrodt, Nestlé, Celltrion, AbbVie , Pfizer , ZonMw , and ECCO. Thomas Kaiser has received a consultation fee, research grant, royalties, or honorarium from Merck Sharp & Dohme, AbbVie, and Nestlé. Anne Griffiths has received consultant fees from AbbVie , Celgene , Gilead , Janssen, Lilly , Merck , and Roche; speaker fees from AbbVie , Janssen, Nestlé, and Shire; and research support from AbbVie . In the last 3 years, Dan Turner has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, Hospital for Sick Children, Ferring, AbbVie, Takeda, Biogen, Atlantic Health, Shire, Celgene, Lilly, Neopharm, and Roche. Amanda Ricciuto discloses no conflicts.

Funding Information:
Funding Funding for and arrangements of the consensus meetings were provided by AbbVie issuing unrestricted grants to the Pediatric Inflammatory Bowel Disease (PIBD) committee. The PIBD committee was solely responsible for all aspects of developing the consensus statements, and the funding source had no role in drafting or voting on the statements.

Funding Information:
Medical writing support was provided by Norah Yao, PhD, and Yangmin Chen, PharmD, of Lighthouse Medical Communications US LLC, and funded by AbbVie.

Publisher Copyright:
© 2021 The Authors

Keywords

Acute Severe Colitis
Cancer
Colectomy
Mortality
Pediatric Ulcerative Colitis
Prediction
Prognostic Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1053/j.gastro.2020.07.066

Cite this

Orlanski-Meyer, E., Aardoom, M., Ricciuto, A., Navon, D., Carman, N., Aloi, M., Bronsky, J., Däbritz, J., Dubinsky, M., Hussey, S., Lewindon, P., Martin De Carpi, J., Navas-López, V. M., Orsi, M., Ruemmele, F. M., Russell, R. K., Veres, G., Walters, T. D., Wilson, D. C., ... Turner, D. (2021). Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program. Gastroenterology, 160(1), 378-402.e22. https://doi.org/10.1053/j.gastro.2020.07.066

@article{345ec004186e4e8aba340422d960e644,

title = "Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program",

abstract = "Background & Aims: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms. Methods: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC. A systematic review of the literature, with selected meta-analysis, was performed to identify studies that investigated predictors for these outcomes. Multiple national and international meetings were held to reach consensus on evidence-based statements. Results: Consensus was reached on 31 statements regarding predictors of colectomy, acute severe colitis (ASC), chronically active pediatric UC, cancer and mortality. At diagnosis, disease extent (6 studies, N = 627; P =.035), Pediatric Ulcerative Colitis Activity Index score (4 studies, n = 318; P <.001), hemoglobin, hematocrit, and albumin may predict colectomy. In addition, family history of UC (2 studies, n = 557; P =.0004), extraintestinal manifestations (4 studies, n = 526; P =.048), and disease extension over time may predict colectomy, whereas primary sclerosing cholangitis (PSC) may be protective. Acute severe colitis may be predicted by disease severity at onset and hypoalbuminemia. Higher Pediatric Ulcerative Colitis Activity Index score and C-reactive protein on days 3 and 5 of hospital admission predict failure of intravenous steroids. Risk factors for malignancy included concomitant diagnosis of primary sclerosing cholangitis, longstanding colitis (>10 years), male sex, and younger age at diagnosis. Conclusions: These evidence-based consensus statements offer predictions to be considered for a personalized medicine approach in treating pediatric UC.",

keywords = "Acute Severe Colitis, Cancer, Colectomy, Mortality, Pediatric Ulcerative Colitis, Prediction, Prognostic Factors",

author = "Esther Orlanski-Meyer and Martine Aardoom and Amanda Ricciuto and Dan Navon and Nicholas Carman and Marina Aloi and Jiri Bronsky and Jan D{\"a}britz and Marla Dubinsky and S{\'e}amus Hussey and Peter Lewindon and {Martin De Carpi}, Javier and Navas-L{\'o}pez, {V{\'i}ctor Manuel} and Marina Orsi and Ruemmele, {Frank M.} and Russell, {Richard K.} and Gabor Veres and Walters, {Thomas D.} and Wilson, {David C.} and Thomas Kaiser and {de Ridder}, Lissy and Anne Griffiths and Dan Turner",

note = "Funding Information: Conflicts of interest These authors disclose the following: Esther Orlanski Meyer and Martine Aardoom have received a consultant fee from AbbVie . Dan Navon is employed by Antelliq Innovation Center, a subsidiary of Merck Sharp & Dohme. Nicholas Carman has received a consultant fee, speaker{\textquoteright}s fee, and travel support from AbbVie. Marina Aloi has received a consultation fee, research grant, royalties, or honorarium from AbbVie. Jiri Bronsky has received consultation fee/honoraria/congress support from AbbVie, Merck Sharp & Dohme, Nutricia, Nestl{\'e}, and Biocodex. Jan D{\"a}britz has received consultation fees, research grants, royalties, or honoraria from AbbVie, Shire/Takeda, Humana, Nestl{\'e}, Ferring, Amgen, Nutricia, and GlaxoSmithKline. Marla Dubinsky is a consultant for AbbVie , Amgen , Arena, Boehringer Ingelheim , Celgene , Eli Lilly , Genentech , Gilead , Janssen, Pfizer , Merck , Prometheus Labs, Projections Research, Rebiotix, and Takeda and has received grant support from AbbVie , Pfizer , and Prometheus Labs. S{\'e}amus Hussey has received a consultation fee or honorarium from AbbVie. Peter Lewindon has received speaker fees from AbbVie , Janssen, and Pfizer . Javier Mart{\'i}n de Carpi has received a consultation fee, research grant, royalties, or honorarium from AbbVie, Abbott, Celgene, Celltrion, Dr. Falk, Foundation for Advanced Education in the Sciences, Ferring, Janssen, Lilly, Merck Sharp & Dohme, Nestl{\'e} Health Science, Nutricia, and Roche. V{\'i}ctor Manuel Navas-L{\'o}pez has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, AbbVie, Takeda, and Nestl{\'e}. Marina Orsi has received a consultation fee, honoraria fee, or travel support from AbbVie, Nutricia-Danone, Mead Johnson, and Ferring. Frank Ruemmele has received speaker fees from Nestl{\'e}, Mead Johnson , Ferring , Merck Sharp & Dohme , Johnson & Johnson , Centocor, and AbbVie; serves as a board member for Johnson & Johnson; and has been invited to Merck Sharp & Dohme France, Nestl{\'e} Nutrition Institute, Nestl{\'e} Health Science, Danone , Mead Johnson , Takeda , Celgene , BioGene, and Arkopharma. Richard K. Russell is supported by a National Health Service Research Scotland Senior Research Fellowship and has received speaker{\textquoteright}s fees, travel support, and/or participated in medical board meetings with Nestl{\'e}, AbbVie, Dr Falk, Takeda, Napp, Mead Johnson, Nutricia, and 4D Pharma. Gabor Veres has received consultation fees from Nestl{\'e}, Danone, and AbbVie. Thomas D. Walters has received a consultation fee, research grant, royalties, or honorarium from Janssen, Merck, AbbVie, Takeda, Nestl{\'e}, and Ferring. David C. Wilson has received a consultation fee, research grant, speaker fee, or conference support from 4D Pharma, AbbVie, Falk, Ferring, Napp, Nestl{\'e}, Predictimmune, and Roche. Lissy de Ridder has received a grant from or had collaborations (such as industry-sponsored studies, investigator-initiated studies, and consultancy) with Shire , Mallinckrodt, Nestl{\'e}, Celltrion, AbbVie , Pfizer , ZonMw , and ECCO. Thomas Kaiser has received a consultation fee, research grant, royalties, or honorarium from Merck Sharp & Dohme, AbbVie, and Nestl{\'e}. Anne Griffiths has received consultant fees from AbbVie , Celgene , Gilead , Janssen, Lilly , Merck , and Roche; speaker fees from AbbVie , Janssen, Nestl{\'e}, and Shire; and research support from AbbVie . In the last 3 years, Dan Turner has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, Hospital for Sick Children, Ferring, AbbVie, Takeda, Biogen, Atlantic Health, Shire, Celgene, Lilly, Neopharm, and Roche. Amanda Ricciuto discloses no conflicts. Funding Information: Funding Funding for and arrangements of the consensus meetings were provided by AbbVie issuing unrestricted grants to the Pediatric Inflammatory Bowel Disease (PIBD) committee. The PIBD committee was solely responsible for all aspects of developing the consensus statements, and the funding source had no role in drafting or voting on the statements. Funding Information: Medical writing support was provided by Norah Yao, PhD, and Yangmin Chen, PharmD, of Lighthouse Medical Communications US LLC, and funded by AbbVie. Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = jan,

doi = "10.1053/j.gastro.2020.07.066",

language = "American English",

volume = "160",

pages = "378--402.e22",

journal = "Gastroenterology",

issn = "0016-5085",

publisher = "W.B. Saunders Ltd",

number = "1",

}

Orlanski-Meyer, E, Aardoom, M, Ricciuto, A, Navon, D, Carman, N, Aloi, M, Bronsky, J, Däbritz, J, Dubinsky, M, Hussey, S, Lewindon, P, Martin De Carpi, J, Navas-López, VM, Orsi, M, Ruemmele, FM, Russell, RK, Veres, G, Walters, TD, Wilson, DC, Kaiser, T, de Ridder, L, Griffiths, A & Turner, D 2021, 'Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program', Gastroenterology, vol. 160, no. 1, pp. 378-402.e22. https://doi.org/10.1053/j.gastro.2020.07.066

Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program. / Orlanski-Meyer, Esther; Aardoom, Martine; Ricciuto, Amanda et al.
In: Gastroenterology, Vol. 160, No. 1, 01.2021, p. 378-402.e22.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization

T2 - Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

AU - Orlanski-Meyer, Esther

AU - Aardoom, Martine

AU - Ricciuto, Amanda

AU - Navon, Dan

AU - Carman, Nicholas

AU - Aloi, Marina

AU - Bronsky, Jiri

AU - Däbritz, Jan

AU - Dubinsky, Marla

AU - Hussey, Séamus

AU - Lewindon, Peter

AU - Martin De Carpi, Javier

AU - Navas-López, Víctor Manuel

AU - Orsi, Marina

AU - Ruemmele, Frank M.

AU - Russell, Richard K.

AU - Veres, Gabor

AU - Walters, Thomas D.

AU - Wilson, David C.

AU - Kaiser, Thomas

AU - de Ridder, Lissy

AU - Griffiths, Anne

AU - Turner, Dan

N1 - Funding Information: Conflicts of interest These authors disclose the following: Esther Orlanski Meyer and Martine Aardoom have received a consultant fee from AbbVie . Dan Navon is employed by Antelliq Innovation Center, a subsidiary of Merck Sharp & Dohme. Nicholas Carman has received a consultant fee, speaker’s fee, and travel support from AbbVie. Marina Aloi has received a consultation fee, research grant, royalties, or honorarium from AbbVie. Jiri Bronsky has received consultation fee/honoraria/congress support from AbbVie, Merck Sharp & Dohme, Nutricia, Nestlé, and Biocodex. Jan Däbritz has received consultation fees, research grants, royalties, or honoraria from AbbVie, Shire/Takeda, Humana, Nestlé, Ferring, Amgen, Nutricia, and GlaxoSmithKline. Marla Dubinsky is a consultant for AbbVie , Amgen , Arena, Boehringer Ingelheim , Celgene , Eli Lilly , Genentech , Gilead , Janssen, Pfizer , Merck , Prometheus Labs, Projections Research, Rebiotix, and Takeda and has received grant support from AbbVie , Pfizer , and Prometheus Labs. Séamus Hussey has received a consultation fee or honorarium from AbbVie. Peter Lewindon has received speaker fees from AbbVie , Janssen, and Pfizer . Javier Martín de Carpi has received a consultation fee, research grant, royalties, or honorarium from AbbVie, Abbott, Celgene, Celltrion, Dr. Falk, Foundation for Advanced Education in the Sciences, Ferring, Janssen, Lilly, Merck Sharp & Dohme, Nestlé Health Science, Nutricia, and Roche. Víctor Manuel Navas-López has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, AbbVie, Takeda, and Nestlé. Marina Orsi has received a consultation fee, honoraria fee, or travel support from AbbVie, Nutricia-Danone, Mead Johnson, and Ferring. Frank Ruemmele has received speaker fees from Nestlé, Mead Johnson , Ferring , Merck Sharp & Dohme , Johnson & Johnson , Centocor, and AbbVie; serves as a board member for Johnson & Johnson; and has been invited to Merck Sharp & Dohme France, Nestlé Nutrition Institute, Nestlé Health Science, Danone , Mead Johnson , Takeda , Celgene , BioGene, and Arkopharma. Richard K. Russell is supported by a National Health Service Research Scotland Senior Research Fellowship and has received speaker’s fees, travel support, and/or participated in medical board meetings with Nestlé, AbbVie, Dr Falk, Takeda, Napp, Mead Johnson, Nutricia, and 4D Pharma. Gabor Veres has received consultation fees from Nestlé, Danone, and AbbVie. Thomas D. Walters has received a consultation fee, research grant, royalties, or honorarium from Janssen, Merck, AbbVie, Takeda, Nestlé, and Ferring. David C. Wilson has received a consultation fee, research grant, speaker fee, or conference support from 4D Pharma, AbbVie, Falk, Ferring, Napp, Nestlé, Predictimmune, and Roche. Lissy de Ridder has received a grant from or had collaborations (such as industry-sponsored studies, investigator-initiated studies, and consultancy) with Shire , Mallinckrodt, Nestlé, Celltrion, AbbVie , Pfizer , ZonMw , and ECCO. Thomas Kaiser has received a consultation fee, research grant, royalties, or honorarium from Merck Sharp & Dohme, AbbVie, and Nestlé. Anne Griffiths has received consultant fees from AbbVie , Celgene , Gilead , Janssen, Lilly , Merck , and Roche; speaker fees from AbbVie , Janssen, Nestlé, and Shire; and research support from AbbVie . In the last 3 years, Dan Turner has received a consultation fee, research grant, royalties, or honorarium from Janssen, Pfizer, Hospital for Sick Children, Ferring, AbbVie, Takeda, Biogen, Atlantic Health, Shire, Celgene, Lilly, Neopharm, and Roche. Amanda Ricciuto discloses no conflicts. Funding Information: Funding Funding for and arrangements of the consensus meetings were provided by AbbVie issuing unrestricted grants to the Pediatric Inflammatory Bowel Disease (PIBD) committee. The PIBD committee was solely responsible for all aspects of developing the consensus statements, and the funding source had no role in drafting or voting on the statements. Funding Information: Medical writing support was provided by Norah Yao, PhD, and Yangmin Chen, PharmD, of Lighthouse Medical Communications US LLC, and funded by AbbVie. Publisher Copyright: © 2021 The Authors

PY - 2021/1

Y1 - 2021/1

N2 - Background & Aims: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms. Methods: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC. A systematic review of the literature, with selected meta-analysis, was performed to identify studies that investigated predictors for these outcomes. Multiple national and international meetings were held to reach consensus on evidence-based statements. Results: Consensus was reached on 31 statements regarding predictors of colectomy, acute severe colitis (ASC), chronically active pediatric UC, cancer and mortality. At diagnosis, disease extent (6 studies, N = 627; P =.035), Pediatric Ulcerative Colitis Activity Index score (4 studies, n = 318; P <.001), hemoglobin, hematocrit, and albumin may predict colectomy. In addition, family history of UC (2 studies, n = 557; P =.0004), extraintestinal manifestations (4 studies, n = 526; P =.048), and disease extension over time may predict colectomy, whereas primary sclerosing cholangitis (PSC) may be protective. Acute severe colitis may be predicted by disease severity at onset and hypoalbuminemia. Higher Pediatric Ulcerative Colitis Activity Index score and C-reactive protein on days 3 and 5 of hospital admission predict failure of intravenous steroids. Risk factors for malignancy included concomitant diagnosis of primary sclerosing cholangitis, longstanding colitis (>10 years), male sex, and younger age at diagnosis. Conclusions: These evidence-based consensus statements offer predictions to be considered for a personalized medicine approach in treating pediatric UC.

AB - Background & Aims: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms. Methods: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC. A systematic review of the literature, with selected meta-analysis, was performed to identify studies that investigated predictors for these outcomes. Multiple national and international meetings were held to reach consensus on evidence-based statements. Results: Consensus was reached on 31 statements regarding predictors of colectomy, acute severe colitis (ASC), chronically active pediatric UC, cancer and mortality. At diagnosis, disease extent (6 studies, N = 627; P =.035), Pediatric Ulcerative Colitis Activity Index score (4 studies, n = 318; P <.001), hemoglobin, hematocrit, and albumin may predict colectomy. In addition, family history of UC (2 studies, n = 557; P =.0004), extraintestinal manifestations (4 studies, n = 526; P =.048), and disease extension over time may predict colectomy, whereas primary sclerosing cholangitis (PSC) may be protective. Acute severe colitis may be predicted by disease severity at onset and hypoalbuminemia. Higher Pediatric Ulcerative Colitis Activity Index score and C-reactive protein on days 3 and 5 of hospital admission predict failure of intravenous steroids. Risk factors for malignancy included concomitant diagnosis of primary sclerosing cholangitis, longstanding colitis (>10 years), male sex, and younger age at diagnosis. Conclusions: These evidence-based consensus statements offer predictions to be considered for a personalized medicine approach in treating pediatric UC.

KW - Acute Severe Colitis

KW - Cancer

KW - Colectomy

KW - Mortality

KW - Pediatric Ulcerative Colitis

KW - Prediction

KW - Prognostic Factors

UR - http://www.scopus.com/inward/record.url?scp=85097458553&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2020.07.066

DO - 10.1053/j.gastro.2020.07.066

M3 - Article

C2 - 32976826

AN - SCOPUS:85097458553

SN - 0016-5085

VL - 160

SP - 378-402.e22

JO - Gastroenterology

JF - Gastroenterology

IS - 1

ER -

Predicting Outcomes in Pediatric Ulcerative Colitis for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

Abstract

Bibliographical note

Keywords

UN SDGs

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