Endoscopic Recurrence 6 Months After Ileocecal Resection in Children With Crohn Disease Treated With Azathioprine

J Pediatr Gastroenterol Nutr. 2017 Aug;65(2):207-211. doi: 10.1097/MPG.0000000000001470.

Abstract

Objectives: Intestinal surgery is an important part of Crohn disease (CD) treatment in children. The aim of the present study was to compare the rate of endoscopic recurrence at the sixth month after ileocecal resection (ICR) in children with CD treated with azathioprine between patients who received prior antitumor necrosis factor alpha (anti-TNF-α) therapy and those who were not administered this therapy. Moreover, we tried to identify the potential risk factors for disease recurrence and describe the schedule of long-term follow-up after surgery.

Methods: We prospectively collected data from pediatric patients with CD, who underwent ICR between October 2011 and June 2015 at our hospital and were treated with azathioprine monotherapy after ICR. We evaluated the endoscopic recurrence (Rutgeerts score) at the sixth month after ICR in all included patients.

Results: Among 21 included patients, 13 achieved endoscopic remission (Rutgeerts score < i2) at the sixth month after ICR. No difference was found between patients who received prior anti-TNF-α therapy and those who did not. We did not find any clinically relevant factors associated with endoscopic recurrence rate at the sixth month.

Conclusions: Prior anti-TNF-α therapy does not seem to be a strong risk factor for endoscopic recurrence within 6 months after ICR. Further studies on large sample of patients are needed to identify potential predictors of disease recurrence.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab / therapeutic use*
  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use
  • Azathioprine / therapeutic use*
  • Cecum / surgery*
  • Child
  • Child, Preschool
  • Colonoscopy
  • Combined Modality Therapy
  • Crohn Disease / diagnostic imaging
  • Crohn Disease / drug therapy*
  • Crohn Disease / surgery
  • Female
  • Follow-Up Studies
  • Gastroscopy
  • Humans
  • Ileum / surgery*
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Infant, Newborn
  • Infliximab / therapeutic use*
  • Male
  • Prospective Studies
  • Recurrence
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Infliximab
  • Adalimumab
  • Azathioprine

Supplementary concepts

  • Pediatric Crohn's disease