23-05-2025
Does Family IBD History Affect Outcomes in Paediatric IBD?
In patients with paediatric-onset inflammatory bowel disease (IBD), a familial history of IBD did not exhibit an increased use of immunomodulators or biologic agents compared with sporadic forms of the disease, but those with Crohn's disease (CD) had a higher need for perianal surgery.
METHODOLOGY:
This observational retrospective case-control study was conducted using a prospectively maintained registry since 2006, focusing on adults diagnosed with paediatric-onset IBD.
This study included patients diagnosed with IBD at the age of 17 years or younger, all of Caucasian ethnicity and born in Spain.
Patients with familial forms of IBD were defined as those having at least one first-degree relative with IBD, and those with sporadic forms of IBD had no family history.
Each patient with a paediatric-onset familial form of IBD was propensity score matched with four patients with paediatric-onset sporadic forms of IBD, and 655 patients with CD and 440 with ulcerative colitis (UC) comprising familial and sporadic forms were included.
Data collected included demographics, IBD diagnosis details, the use of immunomodulators and biologic therapies, and surgery timelines, with a median follow-up duration of 100 and 102 months for patients with CD and UC, respectively.
TAKEAWAY:
Among patients with CD or UC, no significant differences in the percentage of patients exposed to immunomodulators were found between those with familial and sporadic forms of the disease, nor in the median time to the introduction of immunomodulators.
The use of biologic agents did not differ between patients with familial and sporadic forms, with no significant differences in the median time to the initiation of treatment.
Patients with familial forms of CD showed a higher requirement for perianal surgery than those with sporadic forms of CD (18.3% vs 10.5%; odds ratio, 1.91; P = .014).
= .014). No significant differences in the proportion of patients who underwent intestinal resections and total or segmentary colectomies were observed between familial and sporadic forms in those with CD and UC, respectively.
IN PRACTICE:
"Having a family history of IBD in children with IBD should not be a criterion for changing the treatment algorithm or for anticipating a worse prognosis," the authors wrote.
SOURCE:
This study was led by Carlos González-Muñoza, Hospital Santa Creu i Sant Pau, Barcelona, Spain. It was published online on May 12, 2025, in the Journal of Clinical Medicine .
LIMITATIONS:
The registry primarily included adult patients, potentially underrepresenting paediatric-onset IBD cases. The findings may not be generalisable to non-Caucasian populations owing to the homogeneous genetic background of the cohort. The absence of data on genetic polymorphism further limited the study's conclusions.
DISCLOSURES:
This study did not receive any external funding. Some authors reported receiving educational or research funding, travel grants, and advisory fees and serving as consultants and/or speakers for several pharmaceutical companies.
