Pediatric Gastroenterology, Hepatology & Nutrition最新文献

{"title":"Micronutrient Deficiencies in Infants Following Gastrointinal Surgery at the National Children's Hospital.","authors":"Hang Nguyen Thi, Huong Le Thi, Thuy Hong Nguyen Thi, Tien Dat Tran, Le Tuan Anh Nguyen","doi":"10.5223/pghn.2026.29.2.183","DOIUrl":"10.5223/pghn.2026.29.2.183","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the micronutrient status of infants at 1 and 6 months after gastrointestinal surgery and identify the associated factors.</p><p><strong>Methods: </strong>This prospective descriptive study was conducted between February 2023 and August 2024 at the Vietnam National Children's Hospital. Infants who underwent gastrointestinal surgery were monitored for micronutrient deficiency. A total of 120 infants were enrolled, 60 of whom had complete data available for analysis. Among the remaining patients, 12 died from severe infections, and 38 discontinued participation for various reasons, including the high cost of re-examination, lack of time, and follow-up elsewhere. Additional cases were excluded owing to incomplete data for the 6-month follow-up period.</p><p><strong>Results: </strong>The study included 60 infants (58.3% male), all of whom underwent their first gastrointestinal surgery before 3 months of age. Over time, the prevalence of most micronutrient deficiencies decreased, except for zinc and iron deficiencies. One month post-surgery, anemia and vitamin D deficiency were the most common micronutrient deficiencies (55% and 57%, respectively). At 6 months post-surgery, zinc deficiency was the most prevalent (47%), followed by iron deficiency (33%). The 6-month prevalence of zinc deficiency was significantly higher in infants with intestinal failure than in those without it (<i>p</i><0.008). The rate of hyponatremia was significantly higher in infants who underwent enterostomy than in those who did not (<i>p</i><0.001).</p><p><strong>Conclusion: </strong>Infants undergoing gastrointestinal surgery are at risk of persistent micronutrient deficiencies, particularly zinc, vitamin D, and iron deficiencies. Notably, zinc deficiency was more common in infants with intestinal failure than in those without.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"183-194"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Liver Stiffness Measurement as a Non-Invasive Tool for Variceal Screening in Pediatric Chronic Liver Disease: A Systematic Review and Meta-Analysis.","authors":"Kalpana Panda, Devi Prasad Dash, Bramhadatta Pattnaik, Vipul Gautam, Prateek Kumar Panda","doi":"10.5223/pghn.2026.29.2.151","DOIUrl":"10.5223/pghn.2026.29.2.151","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic liver disease (CLD) in children often leads to portal hypertension and varices. Upper GI endoscopy (UGIE) is gold standard for variceal detection; however, it is invasive and requires anesthesia. Liver stiffness measurement (LSM) has emerged as a promising non-invasive alternative for variceal screening. This systematic review and meta-analysis was conducted to evaluate diagnostic accuracy of LSM for predicting any grade of esophageal and/or gastric varices (Vx) and high-risk varices (HRVx) in pediatric CLD.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Embase was conducted to include studies reporting LSM-based diagnostic accuracy data for Vx/HRVx prediction in CLD patients ≤18 years, with UGIE as reference standard. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under receiver operating characteristic curve (AUC) were estimated.</p><p><strong>Results: </strong>Twelve studies (n=647) were included. For prediction of Vx (six studies, n=327), LSM demonstrated pooled sensitivity of 0.85 (95% confidence intervals [CI]: 0.78-0.90), specificity of 0.74 (95% CI: 0.67-0.80), DOR of 16.35 (95% CI: 7.06-40.24), and AUC of 0.847. For HRVx (seven studies, n=369), pooled sensitivity, specificity, DOR and AUC were 0.81 (95% CI: 0.74-0.87), 0.79 (95% CI: 0.73-0.84), 14.19 (95% CI: 5.14-35.98) and 0.862, respectively. Considerable heterogeneity (I²=73.5%) was noted in specificity for HRVx. Subgroup analyses identified LSM modality, cutoff values, ethnicity, and variceal prevalence as sources of heterogeneity.</p><p><strong>Conclusion: </strong>LSM holds promise as a non-invasive tool for variceal screening in pediatric CLD. However, it should be regarded as a complement rather than a replacement for endoscopy until standardized protocols with prospectively validated thresholds are established.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"151-168"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Gastroenterology, Hepatology, and Nutrition Training in the Asia-Pacific Region: An International Survey of Training Centers.","authors":"Mu-Ming Chien, Kathleen McGrath, Po-Yee Leung, Satoshi Nakano, Vikrant Sood, Ruey Terng Ng, Tae Hyeong Kim, Chatmanee Lertudomphonwanit, Andy Darma","doi":"10.5223/pghn.2026.29.2.89","DOIUrl":"10.5223/pghn.2026.29.2.89","url":null,"abstract":"<p><strong>Purpose: </strong>Published data on pediatric gastroenterology, hepatology, and nutrition (PGHN) training centers in the Asia-Pacific region are limited. This study aimed to evaluate the infrastructure, resources, and training opportunities in PGHN centers across the region to inform future development of training programs.</p><p><strong>Methods: </strong>We conducted an international multicenter, cross-sectional survey among Asia-Pacific nations between August 2023 and July 2024.</p><p><strong>Results: </strong>A total of 43 responses were received from 11 countries. Most centers (58.1%) operated with ≤3 specialists, and trainees in these centers were less likely to receive formal supervision or participate in research. Procedural exposure varied significantly: although endoscopy was widely available, 50% of centers reported fewer than 100 colonoscopies performed annually. Access to training in specialized procedures was limited (pH/impedance, 48.8%; high-resolution manometry, 34.9%; intestinal ultrasound, 41.9%), with radiologists performing most liver biopsies and intestinal ultrasounds in many centers.</p><p><strong>Conclusion: </strong>This first comprehensive survey of PGHN training in the Asia-Pacific region identified considerable variations, with key challenges in training infrastructure and procedural exposure. Most centers operate with limited specialist numbers, impacting supervision and research opportunities, and many struggle to meet international volume-based training requirements for essential procedures. Enhanced regional collaboration and alternative training approaches may help address these gaps.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"89-101"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Non-Invasive Biomarkers and Histological Healing in Children with Celiac Disease: Role of Cytokines, Intestinal Fatty Acid-Binding Protein, and Tissue Transglutaminase Antibodies.","authors":"Rajni Kumari, Sadhna B Lal, Satya V Rana, Kaushal K Prasad, Pramod K Gupta, Arun K Sharma","doi":"10.5223/pghn.2026.29.2.102","DOIUrl":"10.5223/pghn.2026.29.2.102","url":null,"abstract":"<p><strong>Purpose: </strong>Data on treatment response in children with celiac disease (CeD), particularly with respect to changes in tissue transglutaminase IgA antibodies (tTGA-IgA), cytokines, intestinal fatty acid-binding protein (I-FABP), and quantitative histology, remain limited. To evaluate the utility of non-invasive parameters (NIPs), including I-FABP, tTGA-IgA, and cytokines, as potential markers of mucosal recovery in pediatric CeD.</p><p><strong>Methods: </strong>This single-center, prospective, observational follow-up study included children with newly diagnosed CeD. Blood and duodenal biopsy samples were obtained at baseline and after 1 year of follow-up.</p><p><strong>Results: </strong>Seventy-nine children who underwent follow-up biopsy at 1 year were analyzed. Significant improvements were observed in anthropometric measures, histological parameters, tTGA-IgA levels, cytokine profiles (tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFN-γ], interleukin [IL]-15, IL-6, and IL-10), and I-FABP levels. tTGA-IgA showed strong correlations with histological indices, including intraepithelial lymphocyte (IEL) count (r=0.554, <i>p</i><0.001), villous height (r=-0.557, <i>p</i><0.001), crypt depth (r=0.553, <i>p</i><0.001), and villous-to-crypt ratio (VCR; r=-0.561, <i>p</i><0.001). TNF-α demonstrated weak correlation with crypt depth (r=0.24, <i>p</i>=0.04) and VCR (r=-0.22, <i>p</i>=0.05). IL-15 levels (r=0.34, <i>p</i>=0.003) and Δcycle threshold (Ct) scores correlated with IEL counts (r=-0.22, <i>p</i>=0.048). IFN-γ ΔCt scores also correlated with IEL counts (r=-0.34, <i>p</i>=0.001).</p><p><strong>Conclusion: </strong>Among the NIPs evaluated, tTGA-IgA showed the strongest correlation with mucosal recovery at 1 year. TNF-α, IL-15, and IFN-γ demonstrated weaker but significant correlations and may have the potential as adjunctive NIP of mucosal healing in pediatric CeD.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"102-119"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing Congenital Sucrase-Isomaltase Deficiency in Children: An Algorithm Using Combined Breath Testing.","authors":"Brett J Hoskins, Jeanette Freeman, Shaija Kutty, Steven D Miller, Jennifer Smith, Ann O Scheimann, Wikrom Karnsakul","doi":"10.5223/pghn.2026.29.2.120","DOIUrl":"10.5223/pghn.2026.29.2.120","url":null,"abstract":"<p><strong>Purpose: </strong>Disaccharidase deficiencies, including sucrase-isomaltase deficiency, can cause chronic gastrointestinal symptoms in children. While duodenal biopsies remain the diagnostic gold standard, results may be confounded by specimen handling variability or secondary mucosal injury. The noninvasive ¹³C sucrose breath test (¹³CSBT) accurately detects sucrase deficiency, including congenital sucrase-isomaltase deficiency (CSID), while the Trio-Smart^® breath test (BT) identifies small intestinal bacterial overgrowth (SIBO), a potential cause of secondary enzyme deficiency.</p><p><strong>Methods: </strong>We conducted a retrospective review of 25 pediatric patients with disaccharidase deficiencies on duodenal biopsy and normal villous architecture. Patients underwent ¹³CSBT and/or Trio-Smart^® BT to evaluate for true CSID or SIBO. Clinical outcomes and treatment responses were assessed.</p><p><strong>Results: </strong>Of 21 patients with low sucrase activities who completed ¹³CSBT, only 7 (33.3%) had abnormal results consistent with CSID. Six patients received sacrosidase, with three reporting symptom improvement. Of 15 patients who underwent Trio-Smart^® breath testing, 9 (60.0%) had abnormal results suggestive of SIBO and responded to antimicrobial treatment. Two patients had abnormal results on both tests. Interestingly, low palatinase levels were associated with abnormal ¹³CSBT in some cases, though not consistently.</p><p><strong>Conclusion: </strong>Biopsy-based diagnosis may overestimate true CSID due to secondary causes or technical artifacts. Combined use of the ¹³CSBT and Trio-Smart^® BT provides a noninvasive strategy to help distinguish primary or secondary sucrase deficiency, improving diagnostic accuracy and avoiding unnecessary lifelong enzyme therapy. We propose a diagnostic algorithm that integrates biopsy and BT results to guide evaluation and reduce misclassification of CSID.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"120-130"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Tolerance and Refeeding Syndrome in Severely Malnourished Children Treated with Oral Nutrition Supplements Compared to F-75/F-100: A Hospital-Based Randomized Controlled Pilot Trial.","authors":"Klara Yuliarti, Lanny Christine Gultom, Cut Nurul Hafifah, Ina Susianti Timan, Merci Monica Boru Pasaribu, Ferry Liwang, Valensia Vivian The, Damayanti Rusli Sjarif","doi":"10.5223/pghn.2026.29.2.169","DOIUrl":"10.5223/pghn.2026.29.2.169","url":null,"abstract":"<p><strong>Purpose: </strong>Current World Health Organization guidelines recommend F-75/F-100 for inpatients and ready-to-use therapeutic foods (RUTF) for outpatients with severe acute malnutrition (SAM). In Indonesia, F-100 continues to be administered after discharge because of limited evidence of RUTF's acceptability and effectiveness in a local setting. Home-prepared F-100 carried the risk of improper mixing and bacterial contamination. Therefore, ready-to-drink oral nutritional supplements (RTD ONS) may serve as alternatives to F-75/F-100. This study aimed to investigate the safety and effectiveness of ONS in hospitalized children with SAM.</p><p><strong>Methods: </strong>This study was a pilot randomized controlled trial comparing the gastrointestinal tolerance of F-75/F-100, high-energy ONS, and standard-energy ONS in 108 hospitalized subjects aged 12-60 months old with complicated SAM. Subjects were monitored for gastrointestinal symptoms and refeeding syndrome.</p><p><strong>Results: </strong>The incidence of vomiting due to the formula was not significantly different among the three groups (<i>p</i>=0.362), as was the incidence of diarrhea, which was 13.9% (F-75/F-100), 16.7% (high-energy ONS), and 11.1% (standard-energy ONS) (<i>p</i>=0.939). The incidences of refeeding syndrome were 13.9%, 5.6%, and 2.8% in the F-75/F-100, standard-energy ONS, and high-energy ONS groups, respectively (<i>p</i>=0.169). The high-energy ONS showed the highest weight increment (8.5±3.2 g/kg/day) among the three groups.</p><p><strong>Conclusion: </strong>Ready-to-drink ONS is a safe and effective therapeutic nutritional option for children with complicated SAM who live in areas with poor sanitation. This study provides preliminary results and requires further investigation to address the limitations of a small sample size and short study timeframe.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"169-182"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Liver Biopsy in Biliary Atresia: Impact of Histological Fibrosis on Kasai Portoenterostomy Outcomes and Decision Making.","authors":"Tawfiq Taki Al Lawati, Omar Saadah, Mohammed Jaafer Al Sajwani, Fatma Ali Ramadhan Al Lawati","doi":"10.5223/pghn.2026.29.2.131","DOIUrl":"10.5223/pghn.2026.29.2.131","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effect of histological fibrosis on liver biopsy at presentation on the decision-making and outcomes of Kasai portoenterostomy (KPE), as well as the subsequent timing of liver transplantation.</p><p><strong>Methods: </strong>A retrospective, cross-sectional study of children <13 years old with biliary atresia (BA) seen at the Royal Hospital between January 2007 and December 2021.</p><p><strong>Results: </strong>Forty children were diagnosed with BA, of whom 31 (77.5%) underwent a liver biopsy, and 26 (65.0%) underwent KPE. Thirty children (96.8%) had either complete or impending cirrhosis. Eleven children (42.3%) who underwent KPE received a liver transplantation at a median age of 26 months (interquartile range [IQR]=33-34). Four children did not undergo KPE, and seven (50.0%) of these underwent liver transplantation at a median age of 22 months (IQR=13-25). The age of liver transplantation did not differ statistically between the KPE group and the primary liver transplantation group (<i>p</i>=0.311). Three children (11.5%) were alive with their native liver following KPE at 5 years. The mortality rate was similar in the KPE and non-KPE groups (<i>p</i>=0.171).</p><p><strong>Conclusion: </strong>Of the 40 children with biliary atresia, 31 had a liver biopsy, with 30 (96.8%) exhibiting either complete or impending cirrhosis. Hepatic fibrosis did not impact the decision to perform KPE. The age of liver transplantation did not differ significantly between the KPE and non-KPE groups (median ages of 26 vs. 22 months, <i>p</i>=0.311).</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"131-140"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Pediatric Dyspepsia: Early Gastric Remodeling as a Unifying Mechanism Behind the Findings of Kim.","authors":"Nav La, Schawanya K Rattanapitoon, Patpicha Arunsan, Nathkapach K Rattanapitoon","doi":"10.5223/pghn.2026.29.2.195","DOIUrl":"10.5223/pghn.2026.29.2.195","url":null,"abstract":"","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"195-196"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of Steatotic Liver in Adolescents and Young Adults in a Northern California Community.","authors":"Julia Vudoan Ernsting, Alexia Tran, Ashkawn Beheshtian, Vivian Nguyen, Bhargava Gannavarapu, Ruel Garcia","doi":"10.5223/pghn.2026.29.2.141","DOIUrl":"10.5223/pghn.2026.29.2.141","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of steatotic liver disease (SLD) in adolescents and young adults (AYA) is poorly understood. While the recognition of the importance of this condition as a precursor to serious liver disease is growing, the impact on young people is not well documented. The majority of SLD data is derived from older subjects undergoing a clinically indicated procedure. This study seeks to better describe the prevalence and associated factors for SLD in AYA.</p><p><strong>Methods: </strong>A convenience sample of 241 patients aged 14-30 in Northern California was recruited. Demographic, dietary, exercise and biometric data were collected. Logistic regression models were applied to assess the association between collected data and body mass index (BMI) categories with SLD presence. A diagnostic cut-off of controlled attenuation parameter ≥238 dB/m on transient elastography was used to define SLD.</p><p><strong>Results: </strong>The prevalence of SLD was 59/241 (24.8%). BMI was a predictor of SLD, with 0.0% (0/12) of underweight, 8.5% (11/129) of normal, 28.1% (18/64) of overweight and 83.3% (30/36) of obese participants having hepatic steatosis in this sample.</p><p><strong>Conclusion: </strong>The prevalence of SLD was unexpectedly high, particularly among subjects who were overweight or obese. The increasing diagnosis of SLD in young populations requires a better understanding of factors that may predict or protect from developing fatty liver. Similar to previous reports, BMI was the main predictor of SLD in our population. This study highlights a possible concerning finding of SLD starting at a young age and for consideration of standardized guidelines for screening in AYA.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 2","pages":"141-150"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Efficacy and Safety of Multi-Matrix Mesalazine Maintenance Therapy in Pediatric Patients with Ulcerative Colitis.","authors":"Toshiaki Shimizu, Daisuke Tokuhara, Shigeo Nishimata, Takashi Ishige, Takahiro Kudo, Masahiro Takatsu, Kanako Nishimura, Akiko Matsuda, Koichi Hayashi, Katsuhiro Arai","doi":"10.5223/pghn.2026.29.1.44","DOIUrl":"10.5223/pghn.2026.29.1.44","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of multi-matrix mesalazine in pediatric patients with ulcerative colitis (UC) in remission.</p><p><strong>Methods: </strong>A multicenter, open-label, uncontrolled study was conducted in Japan, in which multi-matrix mesalazine 40 mg/kg was administered orally once daily for 48 weeks to 23 patients with UC in remission, aged <17 years. The primary endpoint was the nonoccurrence of rectal bleeding based on the Ulcerative Colitis Disease Activity Index (UC-DAI) score.</p><p><strong>Results: </strong>The percentage of patients without rectal bleeding, based on the UC-DAI score in the full analysis set, was 73.9% (two-sided 95% confidence interval [CI]: 51.6%, 89.8%; n=17/23). The lower limit of the two-sided 95% CI exceeded the predetermined threshold of 50%, derived from placebo group data in previous clinical studies involving adult patients with UC. The incidence of adverse events (AEs) and study drug-related AEs was 87.0% (n=20/23) and 13.0% (n=3/23), respectively. No deaths were reported. None of the study drug-related AEs were severe or serious, nor did they lead to discontinuation of the study drug.</p><p><strong>Conclusion: </strong>This study demonstrated the long-term efficacy of multi-matrix mesalazine in pediatric patients with UC in remission in Japan. No noteworthy safety concerns beyond those known to be associated with mesalazine were observed.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 1","pages":"44-54"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}