{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:10:51Z","timestamp":1790100651558,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003977","name":"Israel Science Foundation","doi-asserted-by":"publisher","award":["785\/22"],"award-info":[{"award-number":["785\/22"]}],"id":[{"id":"10.13039\/501100003977","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies highlighted a more extensive phenotype for paediatric\u2010onset than adult\u2010onset inflammatory bowel disease (IBD). However, most lacked long\u2010term follow\u2010up, and some were conducted before the era of biologics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study is to compare disease characteristics and treatment exposures between paediatric\u2010onset and adult\u2010onset IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a registry that periodically and uniformly retrieves demographics, disease characteristics\/phenotype, and treatments, we compared the characteristics of paediatric\u2010onset (diagnosed at \u22656 and &lt;18\u2009years) and adult\u2010onset IBD, diagnosed during 2000\u20132022 and with \u226512\u2009months follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 2837 patients with Crohn's disease and 1332 with ulcerative colitis, 3316 had adult\u2010onset and 853 paediatric\u2010onset IBD. The median follow\u2010up was 6\u2009years. Patients with paediatric\u2010onset presented with more extensive disease and received more intensified therapies, including biologics and JAK inhibitors than those with adult\u2010onset IBD. Paediatric\u2010onset ulcerative colitis showed a higher prevalence of E3 extensive colitis including pancolitis and a greater requirement for systemic steroids, immunomodulators, and biologics than adult\u2010onset ulcerative colitis. Paediatric\u2010onset versus adult\u2010onset Crohn's disease exhibited greater L3 ileocolonic involvement and perianal disease phenotype, and higher exposure to immunomodulators and biologics. Kaplan\u2013Meier curve and Cox proportional hazards analyses showed significantly lower 15\u2010year biologic\u2010free survival from diagnosis among those with paediatric\u2010onset IBD than with adult\u2010onset IBD (<jats:italic>p<\/jats:italic>\u2009=\u2009&lt;0.001), indicating greater and earlier use of biologics in the former.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Paediatric\u2010onset presents with more extensive disease with higher exposures to immunomodulators and biologic therapies than adult\u2010onset IBD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18264","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T06:43:51Z","timestamp":1726037031000},"page":"1435-1446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Differences in disease characteristics and treatment exposures between paediatric and adult\u2010onset inflammatory bowel disease using a registry\u2010based cohort"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1553-5847","authenticated-orcid":false,"given":"Maya","family":"Granot","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital, Sheba Medical Center  Tel\u2010Hashomer Israel"},{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7156-0588","authenticated-orcid":false,"given":"Uri","family":"Kopylov","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Department of Gastroenterology Sheba Medical Center, Tel\u2010Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurit","family":"Loberman\u2010Nachum","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital, Sheba Medical Center  Tel\u2010Hashomer Israel"},{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Krauthammer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital, Sheba Medical Center  Tel\u2010Hashomer Israel"},{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaya Mushka","family":"Abitbol","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sheba Medical Center, Tel\u2010Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-4580","authenticated-orcid":false,"given":"Shomron","family":"Ben\u2010Horin","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Department of Gastroenterology Sheba Medical Center, Tel\u2010Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batia","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital, Sheba Medical Center  Tel\u2010Hashomer Israel"},{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Haberman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Edmond and Lily Safra Children's Hospital, Sheba Medical Center  Tel\u2010Hashomer Israel"},{"name":"School of Medicine, Faculty of Medical and Health Sciences, Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60750-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32448-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2023.05.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izae148"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ygh2.368"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2014.05.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.06.081"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000896"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i14.2217"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15114"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.12.013"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04857.x"},{"issue":"5","key":"e_1_2_10_14_1","first-page":"519","article-title":"Incidence and phenotype at diagnosis of very\u2010early\u2010onset compared with later\u2010onset paediatric inflammatory bowel disease: a population\u2010based study [1988\u20102011]","volume":"11","author":"Bequet E","year":"2017","journal-title":"J Crohns Colitis"},{"issue":"6","key":"e_1_2_10_15_1","first-page":"909","article-title":"The unique disease course of children with very early onset\u2010inflammatory bowel disease","volume":"26","author":"Kelsen JR","year":"2020","journal-title":"Inflamm Bowel Dis"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izz259"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i25.2741"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.12.282"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad301"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181da1db8"},{"issue":"9","key":"e_1_2_10_21_1","first-page":"2011","article-title":"The role of the innate and adaptive immune system in pediatric inflammatory bowel disease","volume":"19","author":"Denson LA","year":"2013","journal-title":"Inflamm Bowel Dis"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12616"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-303864"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.06.079"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318247c32f"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.6.3.225"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-199709000-00017"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41385-018-0114-4"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2019.01.06"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20378"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.10.027"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322339"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00034-7"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30317-3"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000243"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac187"},{"issue":"10","key":"e_1_2_10_37_1","first-page":"652","article-title":"Predictors of aggressive inflammatory bowel disease","volume":"7","author":"Yarur AJ","year":"2011","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030871"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.481"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3182662233"},{"key":"e_1_2_10_41_1","article-title":"The medical management of paediatric Crohn's disease: an ECCO\u2010ESPGHAN guideline update","volume":"15","author":"Rheenen PF","year":"2020","journal-title":"J Crohns Colitis"},{"issue":"2","key":"e_1_2_10_42_1","first-page":"S1","article-title":"The 2023 impact of inflammatory bowel disease in Canada: executive summary","volume":"6","author":"Windsor JW","year":"2023","journal-title":"J Can Assoc Gastroenterol"},{"issue":"6","key":"e_1_2_10_43_1","first-page":"1368","article-title":"Out\u2010of\u2010pocket cost burden in pediatric inflammatory bowel disease: a cross\u2010sectional cohort analysis","volume":"21","author":"Sin AT","year":"2015","journal-title":"Inflamm Bowel Dis"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-023-02473-6"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12317"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17542"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1159\/000447283"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00854-4"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.18264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T12:51:10Z","timestamp":1729774270000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.18264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":47,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/apt.18264"],"URL":"https:\/\/doi.org\/10.1111\/apt.18264","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,10]]},"assertion":[{"value":"2024-06-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}