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, Seamus
AU - Hugot, Jean-Pierre
AU - Kolacek, Sanja
AU - Kolho, Kaija Leena
AU - Lionetti, Paolo
AU - Pcerregaard, 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
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 - Hepatology, and Nutrition, management
KW - clinical guidelines
KW - PRIMARY SCLEROSING CHOLANGITIS
KW - European Crohn's and Colitis Organization
KW - children
KW - PLACEBO-CONTROLLED TRIAL
KW - CONTROLLED MULTICENTER TRIAL
KW - ulcerative colitis
KW - BONE-MINERAL DENSITY
KW - INFLAMMATORY-BOWEL-DISEASE
KW - ORAL 5-AMINOSALICYLIC ACID
KW - POUCH-ANAL ANASTOMOSIS
KW - RANDOMIZED CONTROLLED-TRIAL
KW - European Society for Paediatric Gastroenterology
KW - Pediatric Ulcerative Colitis Activity Index
KW - DOSE URSODEOXYCHOLIC ACID
KW - POPULATION-BASED COHORT
U2 - 10.1097/MPG.0b013e3182662233
DO - 10.1097/MPG.0b013e3182662233
M3 - Article
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 -