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Clinical features and long-term outcomes of pediatric-onset inflammatory bowel disease in a population-based cohort in the Songpa-Kangdong district of Seoul, Korea.

BACKGROUND AND AIMS
The long-term outcomes of pediatric-onset inflammatory bowel disease (pIBD) in non-Caucasian populations are unknown. We, therefore, evaluated and compared the clinical features and long-term outcomes of pIBD with those of adult-onset IBD (aIBD) using a population-based cohort in the Songpa-Kangdong district of Seoul, Korea.


METHODS
Clinical characteristics and prognoses were compared between the two groups: pIBD (defined as <18 years of age at diagnosis) and aIBD (18-59 years of age at diagnosis).


RESULTS
We identified 131 patients with pIBD (48 ulcerative colitis [UC], 83 Crohn's disease [CD]) and 1192 patients with aIBD (866 UC, 326 CD) during 1986-2015. An extensive colitis at diagnosis was more prevalent in pUC than in aUC (45.8% vs. 22.3%, P<0.001), and the overall exposure to corticosteroids, thiopurines, and anti-tumor necrosis factor agents was higher in pUC than in aUC (P<0.001). The cumulative risk of colectomy was higher in pUC than in aUC during a median follow-up of 125.0 and 112.1 months, respectively (8.9% vs. 1.8% at 10 years after diagnosis, P=0.030). Ileocolonic location and inflammatory behavior at diagnosis were more common in pCD than in aCD; however, patients with pCD and aCD did not differ regarding treatment or disease course during a median follow-up of 137.2 and 120.9 months, respectively.


CONCLUSION
Our study showed clear differences between pIBD and aIBD, especially in UC. pUC presents with more extensive diseases and may have a more severe disease course, as suggested by an earlier time to administering medications and performing colectomy.