Clinical outcome of ulcerative colitis with severe onset in children: a multicenter prospective cohort study

摘要

Abstract Background As best practices for treating children with severe-onset ulcerative colitis remain controversial in the era of biologic agents, we prospectively investigated treatments and outcomes in a multicenter cohort.Methods Using a Web-based data registry maintained in Japan between October 2012 and March 2020, we compared management and treatment outcomes in an S1 group defined by a Pediatric Ulcerative Colitis Activity Index of 65 or more points at diagnosis with those in an S0 group defined by an index value below 65.Results Three hundred one children with ulcerative colitis treated at 21 institutions were included, with follow-up for 3.6?±?1.9?years. Among them, 75 (25.0%) were in S1; their age at diagnosis was 12.3?±?2.9?years, and 93% had pancolitis. Colectomy free rates in S1 were 89% after 1?year, 79% after 2, and 74% after 5, significantly lower than for S0 (P?=?0.0003). Calcineurin inhibitors and biologic agents, respectively, were given to 53% and 56% of S1 patients, significantly more than for S0 patients (P?