Paediatric Crohn's Disease

INTRODUCTION: The BELCRO cohort is a prospective, multicentre registry for newly diagnosed paediatric Crohn's disease patients (<18yrs) recruited 2008 - 2010 to identify predictive factors for disease activity and growth.

METHODS: Data from the BELCRO database were evaluated at diagnosis, 24 and 36 months follow up.

RESULTS: At month 36 (M36), data were available on 84 of the 98 patients included at diagnosis. Disease activity evolved as follows: inactive 5 % to 70%, mild 19% to 24% and moderate to severe 76% to 6%. None of the variables: age, gender, diagnostic delay, type of treatment, disease location, disease activity at diagnosis and growth were associated with disease activity at M36. Paediatricians followed significantly less patients with active disease at M36 compared to adult physicians. Sixty % of patients had biologicals as part of their treatment at M36. Adult gastroenterologists initiated biologicals significantly earlier. They were the only factor determining biologicals 'initiation, not disease location nor disease severity at diagnosis. Median BMI z-score evolved from -0,97 (range -5,5 to 2,1) to 0,11 (range -3,4 to 2) and median height z-score from -0,15 (range -3,4 to 1,6) to 0,12 (range -2,3 to 2,3) at M36. None of the variables mentioned above influenced growth over time.

CONCLUSIONS: Current treatment strategies lead to good disease control in the BELCRO cohort after 3 years. Logistic regression analysis did not show any influence of disease location or current treatment strategy on disease activity and growth, but patients under paediatric care had significantly less severe disease at M36.