ArticleJournal of pediatric gastroenterology and nutrition2026
Long-term outcomes of children with ulcerative colitis after acute severe colitis: A GETAID pédiatrique multicenter study.
Article in Journal of pediatric gastroenterology and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesAcute severe colitis (ASC) is a frequent and severe complication of ulcerative colitis (UC) with a high risk of colectomy. Effects of immunosuppressants and anti-tumor necrosis factor (anti-TNF) agents on the risk of colectomy remain debated. We wished to study the evolution of French pediatric-onset UC patients after ASC.
methodsThis retrospective study was conducted in 12 French centers of the GETAID pédiatrique group. Data on patients with UC aged <18 years admitted with ASC (defined as Pediatric Ulcerative Colitis Activity Index [PUCAI] score ≥ 65) between January 2010 and December 2020 were collected at discharge and at 1, 3, and 5 years after admission. The primary outcome was colectomy-free rates at 1 year. Uni- and multivariate analyses were performed to identify prognostic factors associated with the risk of surgery.
resultsOf the 102 patients admitted with ASC, 95 (93%) were treated with corticosteroids. Forty-eight (50%) patients were escalated to second-line therapy, mainly to infliximab. Nine patients (8.8%) underwent colectomy before discharge. Colectomy-free survival rates were 82% at 1 year, 76% at 3 years, and 74% at 5 years. Patients without colectomy were in clinical and biological remission for a long time. In multivariate analysis, new onset UC, treatment with azathioprine or anti-TNF agent, were significantly associated with a lower risk of colectomy.
conclusionsThe rate of colectomy decreases but remains high after an episode of acute colitis despite early use of biotherapies. But long-term outcome of pediatric-onset UC patients seems good with sustained clinical and biological remission.
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