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Article ; Online: Adalimumab vs Infliximab in Pediatric Patients With Crohn's Disease: A Propensity Score Analysis and Predictors of Treatment Escalation.

Bronsky, Jiri / Copova, Ivana / Kazeka, Denis / Lerchova, Tereza / Mitrova, Katarina / Pospisilova, Kristyna / Sulovcova, Miroslava / Zarubova, Kristyna / Hradsky, Ondrej

Clinical and translational gastroenterology

2022 Volume 13, Issue 5, Page(s) e00490

Abstract: Introduction: Two antitumor necrosis factor therapies (infliximab [IFX] and adalimumab [ADA]) have been approved for the treatment of pediatric Crohn's disease (CD) but have not been compared in head-to-head trials. The aim of this study was to compare ... ...

Abstract	Introduction: Two antitumor necrosis factor therapies (infliximab [IFX] and adalimumab [ADA]) have been approved for the treatment of pediatric Crohn's disease (CD) but have not been compared in head-to-head trials. The aim of this study was to compare the efficacy and safety of ADA and IFX by propensity score matching in a prospective cohort of pediatric patients with luminal CD and at least a 24-month follow-up. Methods: Among 100 patients, 75 met the inclusion criteria, and 62 were matched by propensity score. We evaluated time to treatment escalation as the primary outcome and primary nonresponse, predictors of treatment escalation and relapse, serious adverse events, pharmacokinetics, and effect of concomitant immunomodulators as secondary outcomes. Results: There was no difference between ADA and IFX in time to treatment escalation (HR = 0.63 [95% CI 0.31-1.28] P = 0.20), primary nonresponse (P = 0.95), or serious adverse events. The median (interquartile range) trough levels at the primary outcome were 14.05 (10.88-15.40) and 6.15 (2.08-6.58) µg/mL in the ADA and IFX groups, respectively. On a multivariate analysis, the combination of anti-Saccharomyces cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity was a strong independent predictor of treatment escalation (HR 5.19, [95% CI 2.41-11.18], P < 0.0001). The simple endoscopic score for CD, L3 disease phenotype, and use of concomitant immunomodulators for at least the first 6 months revealed a trend toward significance on a univariate analysis. Discussion: Propensity score matching did not reveal substantial differences in efficacy or safety between ADA and IFX. The anti-S. cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity combination is a strong predictor of treatment escalation.
MeSH term(s)	Adalimumab/adverse effects ; Antibodies, Antineutrophil Cytoplasmic ; Child ; Crohn Disease/diagnosis ; Crohn Disease/drug therapy ; Humans ; Immunologic Factors ; Infliximab/therapeutic use ; Propensity Score ; Prospective Studies ; Treatment Outcome
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; Immunologic Factors ; Infliximab (B72HH48FLU) ; Adalimumab (FYS6T7F842)
Language	English
Publishing date	2022-05-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2581516-7
ISSN	2155-384X ; 2155-384X
ISSN (online)	2155-384X
ISSN	2155-384X
DOI	10.14309/ctg.0000000000000490
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Article ; Online: Predictive value of tissue calprotectin for disease recurrence after ileocecal resection in pediatric Crohn's disease.

Zarubova, Kristyna / Fabian, Ondrej / Hradsky, Ondrej / Lerchova, Tereza / Mikus, Filip / Dotlacil, Vojtech / Pos, Lucie / Skaba, Richard / Bronsky, Jiri

Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia

2021 Volume 166, Issue 3, Page(s) 297–303

Abstract: Aim: Detection of possible predictive factors of endoscopic recurrence after ileocecal resection in Crohn's disease could be very beneficial for the individual adjustment of postoperative therapy. The aim of this study was to verify, whether ... ...

Abstract	Aim: Detection of possible predictive factors of endoscopic recurrence after ileocecal resection in Crohn's disease could be very beneficial for the individual adjustment of postoperative therapy. The aim of this study was to verify, whether immunohistochemical detection of calprotectin in resection margins is useful in diagnostics of endoscopic recurrence. Methods: In this study we included pediatric patients with Crohn's disease who underwent ileocecal resection, regardless of pre-operative or post-operative therapy (n=48). We collected laboratory, clinical, surgical, endoscopic and histopathological data at the time of surgery and at 6 months after surgery. The immunohistochemical staining of calprotectin antigen was performed on all paraffin blocks from the resection margins. Results: Out of 48 patients 52% had endoscopic recurrence in the anastomosis (defined by Rutgeerts score) within 6 months after surgery. The number of cells positive for calprotectin in the proximal resection margin was negatively associated with recurrence (P=0.008), as was the elevated level of total calprotectin (from both resection margins). There was no correlation of calprotectin in distal resection margin and endoscopic recurrence. Fecal calprotectin over 100 ug/g (P=0.0005) and high CRP (P<0.001) at 6 months after ileocecal resection and peritonitis (P=0.048) were associated with endoscopic recurrence. Conclusion: Approximately half of the patients developed endoscopic recurrence within 6 months after ileocecal resection. The predictive value of tissue calprotectin is questionable, as it is negatively associated with endoscopic recurrence. There are other potentially useful predictors, such as CRP and fecal calprotectin at 6 months after resection and the presence of peritonitis.
MeSH term(s)	Biomarkers ; Child ; Colonoscopy ; Crohn Disease/diagnosis ; Crohn Disease/surgery ; Feces ; Humans ; Leukocyte L1 Antigen Complex ; Margins of Excision ; Peritonitis ; Recurrence
Chemical Substances	Biomarkers ; Leukocyte L1 Antigen Complex
Language	English
Publishing date	2021-08-24
Publishing country	Czech Republic
Document type	Journal Article
ZDB-ID	17196-7
ISSN	1804-7521 ; 1213-8118 ; 0231-5599 ; 0862-481X
ISSN (online)	1804-7521
ISSN	1213-8118 ; 0231-5599 ; 0862-481X
DOI	10.5507/bp.2021.050
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Article ; Online: Risk factors for dermatological complications of anti-TNF therapy in a cohort of children with Crohn's disease.

Hradsky, Ondrej / Kazeka, Denis / Copova, Ivana / Lerchova, Tereza / Mitrova, Katarina / Pospisilova, Kristyna / Sulovcova, Miroslava / Zarubova, Kristyna / Bronsky, Jiri

European journal of pediatrics

2021 Volume 180, Issue 9, Page(s) 3001–3008

Abstract: Studies showing a substantial frequency of dermatologic complications in paediatric Crohn's disease (CD) patients on anti-tumour necrosis factor (TNF) therapy preferentially include patients treated with infliximab. We aimed to identify risk factors for ... ...

Abstract	Studies showing a substantial frequency of dermatologic complications in paediatric Crohn's disease (CD) patients on anti-tumour necrosis factor (TNF) therapy preferentially include patients treated with infliximab. We aimed to identify risk factors for the cumulative incidence of skin complications in a paediatric cohort receiving either adalimumab or infliximab and found an association between current skin complications and the patient's current clinical condition. This study retrospectively evaluated dermatologic complications in an inception cohort of 100 paediatric CD patients receiving the first anti-TNF (Motol PIBD cohort). Patient data were collected every 3 months. The lesions were classified as psoriatic, atopic dermatitis, or others. We used Cox regression to evaluate the association between predefined variables and the time to complication and a generalised linear mixed model to assess the association between the patient's current condition and the occurrence of complications. Among the 89 included children, 35 (39%) presented with dermatologic lesions. The only predictor associated with any complication was infliximab (versus adalimumab) therapy (hazard ratio [HR]: 2.07; 95% confidence interval [CI]: 1.03-4.17; p = 0.04). Infliximab therapy (HR: 5.5; 95%CI: 1.59-19.06; p = 0.01) and a family history of atopy (HR: 3.4; 95%CI 1.35-8.57, p = 0.002) were associated with early manifestation of atopic dermatitis. Lower C-reactive protein levels (odds ratio [OR], 0.947; 95% CI, - 0.898 to 0.998; p = 0.046) and infliximab (versus adalimumab) were associated with the occurrence of any dermatologic complications (OR, 5.93; 95% CI, 1.59-22.07; p = 0.008).Conclusion: The frequency of skin complications seems high in paediatric CD patients treated with anti-TNF and is even higher in those treated with infliximab. What is Known: •The dermatologic complications occur during treatment with anti-tumour necrosis factor. •The frequency of skin complications in paediatric patients with Crohn's disease is high. What is New: •Infliximab (vs. adalimumab) was identified as a strong risk factor for the cumulative incidence of skin complications. •Lower C-reactive protein levels were associated with the current occurrence of dermatologic complications.
MeSH term(s)	Child ; Crohn Disease/complications ; Crohn Disease/drug therapy ; Humans ; Infliximab/adverse effects ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Tumor Necrosis Factor Inhibitors ; Tumor Necrosis Factor-alpha
Chemical Substances	Tumor Necrosis Factor Inhibitors ; Tumor Necrosis Factor-alpha ; Infliximab (B72HH48FLU)
Language	English
Publishing date	2021-04-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-021-04077-0
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Article ; Online: Time to Relapse in Children with Crohn's Disease Treated with Azathioprine and Nutritional Therapy or Corticosteroids.

Hradsky, Ondrej / Copova, Ivana / Zarubova, Kristyna / Nevoral, Jiri / Bronsky, Jiri

Digestive diseases and sciences

2016 Volume 61, Issue 7, Page(s) 2041–2050

Abstract: Background: The duration of remission has been shown to be longer in patients initially treated with exclusive enteral nutrition (EEN) compared to corticosteroids (CS). However, no published studies required concurrent immunomodulator [6-mercaptopurine ... ...

Abstract	Background: The duration of remission has been shown to be longer in patients initially treated with exclusive enteral nutrition (EEN) compared to corticosteroids (CS). However, no published studies required concurrent immunomodulator [6-mercaptopurine or azathioprine (AZA)] use at the time of diagnosis. Aims: The aims of this retrospective study were to compare the duration of remission between patients initially treated with AZA in combination with CS or EEN and identify predictors of early relapse in these patients. Methods: Data from 65 newly diagnosed children with CD in clinical remission on either EEN or CS and commencing AZA at diagnosis were included. We compared duration of remission using physician global assessment and carried out Cox regression analysis to identify predictors of early relapse. Patients were followed up to the time of first relapse or for at least 12 months. Results: There were no differences in the duration of remission between patients initially treated with EEN or CS (p = 0.978). We identified younger age at diagnosis [hazard ratio (HR) 0.87, 95 CI 0.78-0.98, p = 0.016], lower height Z score at diagnosis (HR 0.61, 95 CI 0.44-0.85, p = 0.003), involvement of the upper gastrointestinal tract (HR 2.69, 95 CI 1.27-5.66, p = 0.009), and elevated platelet count at remission (HR 1.004, 95 CI 1.001-1.008, p = 0.021) as independent predictors of early relapse. Conclusions: Neither induction regime demonstrated longer duration of remission of CD in patients treated with immunomodulators since the time of diagnosis.
MeSH term(s)	Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Azathioprine/administration & dosage ; Azathioprine/therapeutic use ; Child ; Crohn Disease/diet therapy ; Crohn Disease/drug therapy ; Enteral Nutrition ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/therapeutic use ; Recurrence ; Retrospective Studies
Chemical Substances	Adrenal Cortex Hormones ; Immunosuppressive Agents ; Azathioprine (MRK240IY2L)
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-016-4103-8
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Article ; Online: Is It Useful to Monitor Thiopurine Metabolites in Pediatric Patients with Crohn's Disease on Combination Therapy? A Multicenter Prospective Observational Study.

Pospisilova, Kristyna / Siroka, Jitka / Karaskova, Eva / Hradsky, Ondrej / Lerchova, Tereza / Zarubova, Kristyna / Copova, Ivana / Gonsorcikova, Lucie / Velganova-Veghova, Maria / Francova, Irena / Urbanek, Lubor / Geryk, Milos / Mihal, Vladimir / Bronsky, Jiri

Paediatric drugs

2021 Volume 23, Issue 2, Page(s) 183–194

Abstract: Background: The additional value of azathioprine concomitant treatment on infliximab pharmacokinetics in children is not well described yet.: Aims: In the present study, we aimed to describe the relationship between thiopurine metabolite levels, ... ...

Abstract	Background: The additional value of azathioprine concomitant treatment on infliximab pharmacokinetics in children is not well described yet. Aims: In the present study, we aimed to describe the relationship between thiopurine metabolite levels, infliximab trough levels, anti-IFX antibody formation, and clinical and laboratory markers of disease activity in pediatric patients with Crohn's disease, and to assess non-adherence. Methods: Data were collected prospectively during repeated visits from pediatric patients followed for Crohn's disease in two Czech pediatric inflammatory bowel disease centers between January 2016 and June 2017. Thiopurine metabolites (6-thioguanine and 6-methylmercaptopurine) were measured by high-performance liquid chromatography. Infliximab trough levels and anti-IFX antibody serum levels were measured routinely by ELISA. The risk of loss of response to infliximab therapy was also assessed. Results: A significant association between infliximab serum levels and 6-thioguanine erythrocyte levels was observed when tested as categorical variables (63 patients, 321 observations). To predict infliximab levels > 5 µg/mL, we propose a 6-thioguanine cutoff of 278 pmol/8 × 10 Conclusion: Thiopurine metabolite monitoring in pediatric patients with Crohn's disease is useful when optimizing combination therapy. Pediatric patients with undetectable 6-thioguanine levels are more likely to lose response to infliximab therapy. When targeting optimal infliximab levels, the 6-thioguanine cutoff levels in children appear to be higher than in adults.
MeSH term(s)	Adolescent ; Azathioprine/therapeutic use ; Biomarkers ; Child ; Crohn Disease/drug therapy ; Drug Therapy, Combination ; Female ; Humans ; Immunologic Factors/therapeutic use ; Infliximab/therapeutic use ; Longitudinal Studies ; Male ; Mercaptopurine/analogs & derivatives ; Mercaptopurine/analysis ; Prospective Studies
Chemical Substances	Biomarkers ; Immunologic Factors ; 6-methylthiopurine (6V404DV25O) ; Infliximab (B72HH48FLU) ; Mercaptopurine (E7WED276I5) ; Azathioprine (MRK240IY2L)
Language	English
Publishing date	2021-03-11
Publishing country	Switzerland
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	1492748-2
ISSN	1179-2019 ; 1174-5878
ISSN (online)	1179-2019
ISSN	1174-5878
DOI	10.1007/s40272-021-00439-1
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Article ; Online: Endoscopic Recurrence 6 Months After Ileocecal Resection in Children With Crohn Disease Treated With Azathioprine.

Zarubova, Kristyna / Hradsky, Ondrej / Copova, Ivana / Rouskova, Blanka / Pos, Lucie / Skaba, Richard / Bronsky, Jiri

Journal of pediatric gastroenterology and nutrition

2017 Volume 65, Issue 2, Page(s) 207–211

Abstract: Objectives: Intestinal surgery is an important part of Crohn disease (CD) treatment in children. The aim of the present study was to compare the rate of endoscopic recurrence at the sixth month after ileocecal resection (ICR) in children with CD treated ...

Abstract	Objectives: Intestinal surgery is an important part of Crohn disease (CD) treatment in children. The aim of the present study was to compare the rate of endoscopic recurrence at the sixth month after ileocecal resection (ICR) in children with CD treated with azathioprine between patients who received prior antitumor necrosis factor alpha (anti-TNF-α) therapy and those who were not administered this therapy. Moreover, we tried to identify the potential risk factors for disease recurrence and describe the schedule of long-term follow-up after surgery. Methods: We prospectively collected data from pediatric patients with CD, who underwent ICR between October 2011 and June 2015 at our hospital and were treated with azathioprine monotherapy after ICR. We evaluated the endoscopic recurrence (Rutgeerts score) at the sixth month after ICR in all included patients. Results: Among 21 included patients, 13 achieved endoscopic remission (Rutgeerts score < i2) at the sixth month after ICR. No difference was found between patients who received prior anti-TNF-α therapy and those who did not. We did not find any clinically relevant factors associated with endoscopic recurrence rate at the sixth month. Conclusions: Prior anti-TNF-α therapy does not seem to be a strong risk factor for endoscopic recurrence within 6 months after ICR. Further studies on large sample of patients are needed to identify potential predictors of disease recurrence.
MeSH term(s)	Adalimumab/therapeutic use ; Adolescent ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Cecum/surgery ; Child ; Child, Preschool ; Colonoscopy ; Combined Modality Therapy ; Crohn Disease/diagnostic imaging ; Crohn Disease/drug therapy ; Crohn Disease/surgery ; Female ; Follow-Up Studies ; Gastroscopy ; Humans ; Ileum/surgery ; Immunosuppressive Agents/therapeutic use ; Infant ; Infant, Newborn ; Infliximab/therapeutic use ; Male ; Prospective Studies ; Recurrence ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Inflammatory Agents ; Immunosuppressive Agents ; Infliximab (B72HH48FLU) ; Adalimumab (FYS6T7F842) ; Azathioprine (MRK240IY2L)
Language	English
Publishing date	2017-02-28
Publishing country	United States
Document type	Clinical Trial ; Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/MPG.0000000000001470
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Article ; Online: Correction to: Fecal calprotectin is not a clinically useful marker for the prediction of the early nonresponse to exclusive enteral nutrition in pediatric patients with Crohn disease.

Copova, Ivana / Hradsky, Ondrej / Zarubova, Kristyna / Gonsorcikova, Lucie / Potuznikova, Kristyna / Lerchova, Tereza / Nevoral, Jiri / Bronsky, Jiri

European journal of pediatrics

2018 Volume 177, Issue 11, Page(s) 1695

Abstract: This article was originally published with all author names incorrectly listed. All author names have now been transposed and appear correctly above. The original article was corrected. ...

Abstract	This article was originally published with all author names incorrectly listed. All author names have now been transposed and appear correctly above. The original article was corrected.
Language	English
Publishing date	2018-10-02
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-018-3260-5
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Article ; Online: Evaluation of Infliximab Therapy in Children with Crohn's Disease Using Trough Levels Predictors.

Ohem, Jan / Hradsky, Ondrej / Zarubova, Kristyna / Copova, Ivana / Bukovska, Petra / Prusa, Richard / Malickova, Karin / Bronsky, Jiri

Digestive diseases (Basel, Switzerland)

2018 Volume 36, Issue 1, Page(s) 40–48

Abstract: Background: In adults, infliximab (IFX) levels correlate with disease activity, and antibodies to IFX (ATIs) predict treatment failure. We aimed to determine the association of IFX levels and ATIs with disease activity in a paediatric population. We ... ...

Abstract	Background: In adults, infliximab (IFX) levels correlate with disease activity, and antibodies to IFX (ATIs) predict treatment failure. We aimed to determine the association of IFX levels and ATIs with disease activity in a paediatric population. We prospectively collected blood, stool, and clinical data from 65 patients (age 10.5-15.1 years) with Crohn's disease (CD) before IFX administration, and measured IFX trough levels, ATIs, and faecal calprotectin levels (CPT). Samples were collected during maintenance therapy. We used multivariate analysis to identify the predictors of IFX levels. Summary: Lower levels of IFX were associated with ATIs positivity (OR 0.027, 95% CI 0.009-0.077). Higher C-reactive protein (CRP) level, erythrocyte sedimentation rate, and CPT levels were found in patients with lower IFX levels. The optimal combination of sensitivity (0.5) and specificity (0.74) for disease activity was calculated for IFX levels ≥1.1 µg/mL using CRP level <5 mg/L as a marker of laboratory remission. In a model that used CPT ≤100 µg/g as the definition of remission, the optimal IFX trough level was 3.5 µg/mL. No independent association between remission and ATIs was found in our study population. However, we found an independentz association between IFX levels and serum albumin levels (OR 1.364, 95% CI 1.169-1.593), p < 0.001. Key Messages: The paediatric population was similar to adult populations in terms of the association between IFX and ATIs as well as between IFX and disease activity.
Language	English
Publishing date	2018
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	632798-9
ISSN	1421-9875 ; 0257-2753
ISSN (online)	1421-9875
ISSN	0257-2753
DOI	10.1159/000477962
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Article ; Online: Fecal calprotectin is not a clinically useful marker for the prediction of the early nonresponse to exclusive enteral nutrition in pediatric patients with Crohn disease.

Copova, Ivana / Hradsky, Ondrej / Zarubova, Kristyna / Gonsorcikova, Lucie / Potuznikova, Kristyna / Lerchova, Tereza / Nevoral, Jiri / Bronsky, Jiri

European journal of pediatrics

2018 Volume 177, Issue 11, Page(s) 1685–1693

Abstract: Exclusive enteral nutrition (EEN) has been recommended as the first-line therapy in children with active Crohn disease (CD). The primary aim of our study was to determine whether it is possible to use the difference between basal fecal calprotectin (F- ... ...

Abstract	Exclusive enteral nutrition (EEN) has been recommended as the first-line therapy in children with active Crohn disease (CD). The primary aim of our study was to determine whether it is possible to use the difference between basal fecal calprotectin (F-CPT) and the value at week 2 of EEN to predict clinical response at week 6. We prospectively collected stool samples for F-CPT analysis and clinical and laboratory parameters during EEN from 38 pediatric patients (28 boys, median age 12.8 years) with newly diagnosed active luminal CD. The difference between F-CPT concentrations before EEN and at week 2 did not predict clinical non-response at week 6 (OR 0.9996 95% CI 0.9989-1.0002, p = 0.18); however, it predicted patients who did not achieve clinical remission at week 6 (OR 0.9993, 95% CI 00.9985-0.9998, p = 0.006) with sensitivity of 58%, and specificity of 92% for cut-off of F-CPT increase by 486 μg/g.Conclusions: An early decrease in F-CPT levels in children with newly diagnosed active luminal CD did not predict clinical response at week 6 of EEN induction therapy, and clinical remission was predicted with low accuracy. Therefore, F-CPT cannot be used as a predictor to select the patients in whom EEN should be terminated. What is Known: • The fecal calprotectin (F-CPT) is an important marker of intestinal inflammation. • Approximately 25% of pediatric patients with Crohn disease (CD) do not achieve clinical remission, and there is still no sufficient predictor of response to exclusive enteral nutrition (EEN) treatment. What is New: • The difference between the F-CPT concentrations before EEN treatment and at week 2 did not predict clinical response to treatment at week 6, even if it predicted clinical remission, however, with low accuracy. F-CPT is not a suitable predictor to select the patients for discontinuing of EEN induction therapy.
MeSH term(s)	Adolescent ; Biomarkers/analysis ; Child ; Crohn Disease/metabolism ; Crohn Disease/therapy ; Enteral Nutrition/adverse effects ; Feces/chemistry ; Female ; Humans ; Leukocyte L1 Antigen Complex/analysis ; Male ; Prospective Studies ; Sensitivity and Specificity ; Treatment Outcome
Chemical Substances	Biomarkers ; Leukocyte L1 Antigen Complex
Language	English
Publishing date	2018-08-20
Publishing country	Germany
Document type	Journal Article ; Observational Study
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-018-3228-5
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Article ; Online: Supplementation with 2000 IU of Cholecalciferol Is Associated with Improvement of Trabecular Bone Mineral Density and Muscle Power in Pediatric Patients with IBD.

Hradsky, Ondrej / Soucek, Ondrej / Maratova, Klara / Matyskova, Jana / Copova, Ivana / Zarubova, Kristyna / Bronsky, Jiri / Sumnik, Zdenek

Inflammatory bowel diseases

2017 Volume 23, Issue 4, Page(s) 514–523

Abstract: Background: Inflammatory bowel diseases (IBD) are associated with altered bone health and increased risk for fractures. Vitamin D deficiency is frequently found in IBD; however, the effect of vitamin D supplementation on bone health of children with IBD ...

Abstract	Background: Inflammatory bowel diseases (IBD) are associated with altered bone health and increased risk for fractures. Vitamin D deficiency is frequently found in IBD; however, the effect of vitamin D supplementation on bone health of children with IBD is poorly understood. We aimed to observe the changes in volumetric bone density and dynamic muscle functions after vitamin D substitution in a cohort of pediatric patients with IBD. Methods: This was a prospective observational study of 55 patients (aged 5-19 years) with IBD. Bone quality was assessed using peripheral quantitative computed tomography and muscle functions by jumping mechanography at baseline and after a median of 13.8 (interquartile range, 12.0-16.0) months of daily substitution of 2000 IU of cholecalciferol. Results: Median serum levels of 25-hydroxyvitamin D increased from 58 nmol/L at the baseline visit to 85 nmol/L at the last follow-up visit (P < 0.001); no signs of overdose were reported. The Z-scores of trabecular bone mineral density, cortical bone cross-sectional area, and maximal muscle power improved significantly during the follow-up period (+0.5, P = 0.001, +0.3, P = 0.002 and +0.5, P = 0.002, respectively). Cholecalciferol substitution was positively associated with trabecular bone mineral density and maximal muscle power (estimates 0.26, 95% confidence interval 0.14-0.37, P < 0.0001 and 0.60, 95% confidence interval 0.32-0.85, P < 0.0001, respectively) but not with the Strength-Strain Index or maximal muscle force (Fmax). Conclusions: We observed an improvement in bone and muscle parameters after cholecalciferol substitution in pediatric patients with IBD. Therefore, vitamin D substitution can be considered in such patients.
MeSH term(s)	Adolescent ; Bone Density/drug effects ; Bone Density Conservation Agents/administration & dosage ; Cancellous Bone/drug effects ; Child ; Child, Preschool ; Cholecalciferol/administration & dosage ; Dietary Supplements ; Female ; Humans ; Inflammatory Bowel Diseases/physiopathology ; Inflammatory Bowel Diseases/therapy ; Male ; Muscle Strength/drug effects ; Prospective Studies ; Treatment Outcome ; Young Adult
Chemical Substances	Bone Density Conservation Agents ; Cholecalciferol (1C6V77QF41)
Language	English
Publishing date	2017-03-07
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1097/MIB.0000000000001047
Database	MEDical Literature Analysis and Retrieval System OnLINE

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