| Predictors of immunomodulator use as early therapy in pediatric Crohn's disease. | |
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MedLine Citation:
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PMID: 16394876 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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GOALS: The goals of this study were to identify markers in a patient's presentation and disease progression that predict the need for the use of immunomodulators in a pediatric population. BACKGROUND: Although immunomodulator safety and efficacy have been documented in Crohn's disease, models for predicting outcome and the need for immunomodulators (azathioprine, 6-mercaptopurine, or methotrexate) early in the disease course have not been investigated in children or adults. METHODS: Data on newly diagnosed Crohn's disease patients were prospectively collected within 3 weeks of diagnosis, 6 months after diagnosis, and 1 year after diagnosis. Information collected at each visit included medication use and disease activity assessment. RESULTS: A total of 57 patients who were followed for > or = 6 months were evaluated. Overall, 34 of 57 (59.6%) were started on immunomodulators within 1 year of diagnosis. Mean serum albumin (3.35 g/dL vs. 3.7 g/dL, P = 0.013) and hematocrit (33.3% vs. 35.9%, P = 0.023) at diagnosis were lower, and erythrocyte sedimentation rate (32 vs. 12, P = 0.011) at diagnosis was higher in patients who required immunomodulators. The total Pediatric Crohn's Disease Activity Index score as well as the physical examination score and patient recall score within the PCDAI at diagnosis were not different among those who received immunomodulators and those that did not. CONCLUSIONS: Immunomodulators are frequently used within 1 year of diagnosis in pediatric Crohn's disease. Lower serum albumin levels and hematocrit, and elevated erythrocyte sedimentation rate at diagnosis may predict the need for immunomodulators earlier in the disease course. |
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Authors:
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Douglas A Jacobstein; Petar Mamula; Jonathan E Markowitz; Mary Leonard; Robert N Baldassano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 40 ISSN: 0192-0790 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-05 Completed Date: 2006-04-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 145-8 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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6-Mercaptopurine
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therapeutic use* Adolescent Azathioprine / therapeutic use* Biological Markers / blood* Chi-Square Distribution Child Child, Preschool Crohn Disease / blood*, drug therapy* Disease Progression Female Humans Immunosuppressive Agents / therapeutic use* Male Methotrexate / therapeutic use* Predictive Value of Tests Prospective Studies Statistics, Nonparametric |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Immunosuppressive Agents; 446-86-6/Azathioprine; 50-44-2/6-Mercaptopurine; 59-05-2/Methotrexate |
| Comments/Corrections | |
Comment In:
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J Clin Gastroenterol. 2006 Feb;40(2):93-5
[PMID:
16394867
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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