Escalating anti-tumour necrosis factor exposure with reductions in surgical resection rates in paediatric inflammatory bowel disease: an 18-year real-world population-based cohort study - Scorecard - MDSpire
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Escalating anti-tumour necrosis factor exposure with reductions in surgical resection rates in paediatric inflammatory bowel disease: an 18-year real-world population-based cohort study
Clinical Scorecard: Increasing Exposure to Anti-Tumour Necrosis Factor and Its Impact on Surgical Resection Rates in Pediatric Inflammatory Bowel Disease: An 18-Year Population-Based Cohort Analysis
At a Glance
Category
Detail
Condition
Pediatric Inflammatory Bowel Disease
Key Mechanisms
Anti-tumour necrosis factor (TNF) therapy reduces the need for surgical interventions.
Target Population
Children aged ≤17 years with inflammatory bowel disease.
Care Setting
Regional pediatric gastroenterology center
Key Highlights
Anti-TNF prevalence increased from 5.9% to 61.1% over the study period.
Surgical resection rates declined from 3.93% to 1.09% across three epochs.
Crohn's disease surgery rates significantly decreased, while ulcerative colitis rates did not show significant changes.
Time to anti-TNF treatment from diagnosis decreased significantly.
No additional reduction in surgery-free survival was observed with earlier anti-TNF initiation.
Guideline-Based Recommendations
Diagnosis
Diagnosis of IBD follows modified Porto criteria.
Management
Adoption of anti-TNF therapy has shifted from a step-up to a top-down approach.
Monitoring & Follow-up
Monitor surgical intervention rates and anti-TNF treatment efficacy.
Risks
Potential overtreatment and the need for optimized biologic treatment strategies.
Patient & Prescribing Data
Children diagnosed with IBD under the care of a pediatric gastroenterology center.
Increased anti-TNF use is associated with declining surgical resection rates.
Clinical Best Practices
Utilize anti-TNF therapy early in the treatment course for high-risk patients.
Regularly assess the need for surgical interventions in pediatric IBD patients.
by Zachary Green, Myrna Nicholas, Stephanie Vuijk, Mike Stanton, Christopher Bakewell, Tracy Coelho, Akshay Batra, Nadeem A Afzal, Sarah Ennis, Robert Mark Beattie, James Ashton
