Long-term clinical course, treatment patterns, and prognosis in pediatric-onset vs. adult-onset IBD: a multicenter retrospective cohort study in Korea

作者：Yong-Eun Park, Su Bum Park, Sang-Bum Kang, Yehyun Park, Dae Sung Kim, Soo-Young Na, W. Moon · 发表于：BMC Gastroenterology · 年份：2026 · DOI：10.1186/s12876-026-04630-x · 被引用次数：1 · 研究领域：Medicine

This study aimed to compare the long-term clinical characteristics, treatment patterns, and prognosis of inflammatory bowel disease (IBD) in patients diagnosed before and after 18 years of age. A retrospective study was conducted using data from 384 patients with IBD with a disease duration exceeding 10 years across five hospitals. Baseline characteristics, disease status, and treatment patterns were analyzed at diagnosis, 5 years, 10 years, and present. Of the 384 patients, 84 (21.9%) and 300 (78.1%) were diagnosed before and at or older than the age of 18 years, respectively. Patients diagnosed before 18 years of age more frequently presented with Crohn’s disease (CD) (83.3% vs. 40.0%), whereas ulcerative colitis (UC) was predominant in those diagnosed later (16.7% vs. 60.0%). Younger patients had a significantly higher prevalence of abdominal pain (64.3% vs. 48.7%), malnutrition/weight loss (21.4% vs. 10.7%), and anal fistulas/abscesses (26.2% vs. 5.7%) at the time of diagnosis. Younger patients had more pancolitis-type UC (50% vs. 32.2%) and more perianal diseases in the CD group (51.4% vs. 20.8%). Younger patients initially exhibited higher rates of steroid usage, with a gradual shift towards biologics, such as infliximab. Multivariable Cox regression identified discontinuation of biologic therapy during follow-up as a significant risk factor for disease recurrence. Our findings suggest that the age at IBD onset significantly is associated with disease progression and tr...