ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2024
Progression of Pediatric Crohn's Disease Is Associated With Anti-Tumor Necrosis Factor Timing and Body Mass Index Z-Score Normalization.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Nomogram for predicting 6-month BMIZ changes in children with Crohn's disease: a single-center retrospective study.BMC pediatrics · 2026Article
- The prognostic role of magnetic resonance enterography at diagnosis in paediatric isolated ileocaecal Crohn's disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- FT-MDNNMDs: early detection of breast cancer using fine-tuned multi-deep neural networks with TCGA and clinical image datasets.Scientific reports · 2026Article
- Short Ileal Microvillus Length Phenotype Associates with Progression from Inflammatory to Complicated Disease Behavior in Pediatric Crohn's Disease.Inflammatory bowel diseases · 2026Article
- Multimodal biomarkers and prediction models for stricturing and penetrating progression in Crohn's disease.Frontiers in medicine · 2026Review
- Baseline terminal ileal CT and MRI measurements are associated with imaging outcomes in pediatric Crohn's disease: a cohort study.Pediatric radiology · 2025Article
- [Position paper of the Society for Paediatric Gastroenterology and Nutrition (GPGE) on the off-label use of biologics and signal inhibitors in children and adolescents with IBD that have already been approved for adults].Zeitschrift fur Gastroenterologie · 2025Article
- MRI based early Temporal Lobe Epilepsy detection using DGWO based optimized HAETN and Fuzzy-AAL Segmentation Framework (FASF).PloS one · 2025Article
- Hybridization of synergistic swarm and differential evolution with graph convolutional network for distributed denial of service detection and mitigation in IoT environment.Scientific reports · 2024Article
- Pediatric stricturing Crohn's disease.World journal of gastroenterology · 2024Article
- Early intervention with Ustekinumab is associated with higher rates of clinical and endoscopic remission in patients with Crohn's disease.Therapeutic advances in gastroenterology · 2024Article
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18 authors.
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Abstract
BACKGROUND &
aimsThe evolution of complicated pediatric Crohn's disease (CD) in the era of anti-tumor necrosis factor (aTNF) therapy continues to be described. Because CD progresses from inflammatory to stricturing (B2) and penetrating (B3) disease behaviors in a subset of patients, we aimed to understand the risk of developing complicated disease behavior or undergoing surgery in relation to aTNF timing and body mass index z-score (BMIz) normalization.
methodsMulticenter, 5-year longitudinal data from 1075 newly diagnosed CD patients were analyzed. Descriptive statistics, univariate and stepwise multivariate Cox proportional hazard regression (CPHR), and log-rank analyses were performed for risk of surgery and complicated disease behaviors. Differential gene expression from ileal bulk RNA sequencing was correlated with outcomes.
resultsStricturing complications had the largest increase: from 2.98% to 10.60% over 5 years. Multivariate CPHR showed aTNF exposure within 3 months from diagnosis (hazard ratio [HR], 0.33; 95% CI, 0.15-0.71) and baseline L2 disease (HR, 0.29; 95% CI, 0.09-0.92) to be associated with reduced B1 to B2 progression. For children with a low BMIz at diagnosis (n = 294), multivariate CPHR showed BMIz normalization within 6 months of diagnosis (HR, 0.47; 95% CI, 0.26-0.85) and 5-aminosalicyclic acid exposure (HR, 0.32; 95% CI, 0.13-0.81) were associated with a decreased risk for surgery while B2 (HR, 4.20; 95% CI, 1.66-10.65) and B2+B3 (HR, 8.24; 95% CI, 1.08-62.83) at diagnosis increased surgery risk. Patients without BMIz normalization were enriched for genes in cytokine production and inflammation.
conclusionsaTNF exposure up to 3 months from diagnosis may reduce B2 progression. In addition, lack of BMIz normalization within 6 months of diagnosis is associated with increased surgery risk and a proinflammatory transcriptomic profile.
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