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 - Summary - 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
To evaluate the relationship between anti-tumour necrosis factor (TNF) use and surgical resection rates in a regional paediatric inflammatory bowel disease (IBD) cohort.
Approach:
Data Collection: Data on abdominal surgery rates and anti-TNF administration were collected, and prevalence was calculated.
Epoch Comparison: Three anti-TNF epochs were compared: Epoch-1 (2007–2013), Epoch-2 (2014–2020), Epoch-3 (2021–2024).
Key Findings:
1,538 children included: 915 with Crohn’s disease (CD), 529 with ulcerative colitis (UC), and 94 IBD-unclassified.
Median age at diagnosis was 13.3 years; prevalent population increased from 253 to 597 patients.
Anti-TNF-treated prevalence rose across epochs: 5.9% (Epoch-1), 31.9% (Epoch-2), 61.1% (Epoch-3) (p<0.001).
Resection rates declined from 3.93% (Epoch-1) to 1.09% (Epoch-3) (p=0.003), with no significant decrease from Epoch-2 to Epoch-3 (p=0.217).
CD surgery rates significantly decreased (4.9%, 1.7%, 1.5%, p=0.006); UC rates did not reach significance.
Interpretation:
Limitations:
Retrospective design may introduce bias.
Data on patient attrition due to relocation outside the region was not systematically collected.
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
