TY - JOUR
T1 - Management of pediatric ulcerative colitis
T2 - Joint ECCO and ESPGHAN evidence-based consensus guidelines
AU - Turner, Dan
AU - Levine, Arie
AU - Escher, Johanna C.
AU - Griffiths, Anne M.
AU - Russell, Richard K.
AU - Dignass, Axel
AU - Dias, Jorge Amil
AU - Bronsky, Jiri
AU - Braegger, Christian P.
AU - Cucchiara, Salvatore
AU - De Ridder, Lissy
AU - Fagerberg, Ulrika L.
AU - Hussey, Séamus
AU - Hugot, Jean Pierre
AU - Kolacek, Sanja
AU - Kolho, Kaija Leena
AU - Lionetti, Paolo
AU - Pærregaard, Anders
AU - Potapov, Alexander
AU - Rintala, Risto
AU - Serban, Daniela E.
AU - Staiano, Annamaria
AU - Sweeny, Brian
AU - Veerman, Gigi
AU - Veres, Gabor
AU - Wilson, David C.
AU - Ruemmele, Frank M.
PY - 2012/9
Y1 - 2012/9
N2 - Background and Aims: Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR) of the literature and a robust consensus process. The present article is a product of a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Methods: A group of 27 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to ESPGHAN and ECCO members. A list of 23 predefined questions were addressed by working subgroups based on a SR of the literature. Results: A total of 40 formal recommendations and 68 practice points were endorsed with a consensus rate of at least 89% regarding initial evaluation, how to monitor disease activity, the role of endoscopic evaluation, medical and surgical therapy, timing and choice of each medication, the role of combined therapy, and when to stop medications. A management flowchart, based on the Pediatric Ulcerative Colitis Activity Index (PUCAI), is presented. Conclusions: These guidelines provide clinically useful points to guide the management of UC in children. Taken together, the recommendations offer a standardized protocol that allows effective, timely management and monitoring of the disease course, while acknowledging that each patient is unique.
AB - Background and Aims: Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR) of the literature and a robust consensus process. The present article is a product of a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Methods: A group of 27 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to ESPGHAN and ECCO members. A list of 23 predefined questions were addressed by working subgroups based on a SR of the literature. Results: A total of 40 formal recommendations and 68 practice points were endorsed with a consensus rate of at least 89% regarding initial evaluation, how to monitor disease activity, the role of endoscopic evaluation, medical and surgical therapy, timing and choice of each medication, the role of combined therapy, and when to stop medications. A management flowchart, based on the Pediatric Ulcerative Colitis Activity Index (PUCAI), is presented. Conclusions: These guidelines provide clinically useful points to guide the management of UC in children. Taken together, the recommendations offer a standardized protocol that allows effective, timely management and monitoring of the disease course, while acknowledging that each patient is unique.
KW - European Crohn's and Colitis Organization
KW - European Society for Paediatric Gastroenterology
KW - Hepatology
KW - Pediatric Ulcerative Colitis Activity Index
KW - and Nutrition
KW - children
KW - clinical guidelines
KW - management
KW - ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=84865718633&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/MPG.0b013e3182662233
DO - https://doi.org/10.1097/MPG.0b013e3182662233
M3 - مقالة
C2 - 22773060
SN - 0277-2116
VL - 55
SP - 340
EP - 361
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 3
ER -