Evolving Trends in Pediatric Inflammatory Bowel Disease Management in Japan: A Decade of Nationwide Data

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-05-14 DOI:10.1002/jgh3.70175

Miki Urushiyama, Kunio Tarasawa, Rintaro Moroi, Hideya Iwaki, Yusuke Hoshi, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Fumihiko Kakuta, Hisashi Shiga, Shin Hamada, Yoichi Kakuta, Kiyohide Fushimi, Yoshitaka Kinouchi, Daiki Abukawa, Kenji Fujimori, Atsushi Masamune

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Abstract

Aims

This study aimed to investigate the trends in pediatric inflammatory bowel diseases (IBD) management in Japan over the past decade.

Methods

We retrospectively analyzed data from Japan's nationwide database from 2012 to 2022. Patients aged ≤ 15 years diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) were included. Trends in the use of biologics, capsule endoscopy, total parenteral nutrition (TPN), elemental diets, surgery, and granulocyte and monocyte apheresis (GMA) were examined using the Cochrane–Armitage and Jonckheere–Terpstra trend tests.

Results

Among the 8037 and 6153 pediatric UC and CD admissions, respectively, the use of biologics increased significantly (CD: from 46.0% to 53.6%; UC: from 15.0% to 33.0%, p < 0.0001). The use of capsule endoscopy in pediatric patients with CD increased markedly from 6.6% to 16.7% (p < 0.0001), whereas TPN use decreased from 8.4% to 3.0% (p < 0.0001). Surgery rates for patients with CD remained at approximately 5%, whereas those for patients with UC decreased (from 3.7% to 1.7%, p = 0.002). Elemental diets for pediatric patients with CD increased (from 54.4% to 66.2%, p < 0.0001). The use of GMA decreased significantly in patients with UC (from 12.1% to 2.7%, p < 0.0001).

Conclusion

The use of biologics and capsule endoscopy has increased in pediatric patients with IBD, whereas the use of more invasive treatments has decreased. These trends suggest a shift toward less invasive and more targeted therapeutic strategies in managing pediatric patients with IBD in Japan.

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日本儿童炎症性肠病管理的发展趋势：十年的全国数据

本研究旨在调查过去十年来日本儿童炎症性肠病（IBD）治疗的趋势。方法回顾性分析2012年至2022年日本全国数据库的数据。年龄≤15岁诊断为克罗恩病（CD）或溃疡性结肠炎（UC）的患者被纳入研究。使用Cochrane-Armitage和Jonckheere-Terpstra趋势试验检查生物制剂、胶囊内窥镜、全肠外营养（TPN）、元素饮食、手术以及粒细胞和单核细胞分离（GMA）的使用趋势。结果分别在8037例和6153例儿科UC和CD入院患者中，生物制剂的使用显著增加(CD：从46.0%增加到53.6%；UC：从15.0%到33.0%,p < 0.0001)。儿科CD患者胶囊内窥镜的使用从6.6%显著增加到16.7% (p < 0.0001)，而TPN的使用从8.4%下降到3.0% （p < 0.0001）。CD患者的手术率保持在约5%，而UC患者的手术率下降（从3.7%降至1.7%,p = 0.002）。儿科乳糜泻患者的基本饮食增加（从54.4%增加到66.2%,p < 0.0001）。UC患者GMA的使用显著下降（从12.1%降至2.7%,p < 0.0001）。结论：在IBD患儿中，生物制剂和胶囊内镜的使用有所增加，而侵入性治疗的使用有所减少。这些趋势表明，在日本，IBD患儿的治疗策略转向了侵入性更小、更有针对性的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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