Miki Urushiyama ¹, Kunio Tarasawa ², Rintaro Moroi ¹, Hideya Iwaki ¹, Yusuke Hoshi ³, Hiroshi Nagai ¹, Yusuke Shimoyama ¹, Takeo Naito ¹, Fumihiko Kakuta ³, Hisashi Shiga ¹, Shin Hamada ¹, Yoichi Kakuta ¹, Kiyohide Fushimi ⁴, Yoshitaka Kinouchi ¹, Daiki Abukawa ³, Kenji Fujimori ², Atsushi Masamune ¹

JGH Open. . 2025 May 14;9(5):e70175. doi: 10.1002/jgh3.70175. eCollection 2025 May.

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.

Yue Feng, Weihua Feng, Mei Xu, Chaoping Wu, Huanhuan Yang, Yu Wang, Huatian Gan, Rev Esp Enferm Dig 2023. doi:
10.17235/reed.2023.9808/2023.

Background: the association between sarcopenia and treatment outcomes in inflammatory bowel disease (IBD) is currently a subject of controversy.
Methods: a systematic search was performed of PubMed, Embase, Web of Science, and the Cochrane Library for studies published until April 2023. The quality assessment of each included study was performed using the Newcastle-Ottawa
Scale.
Results: seventeen studies were included with 2,895 IBD patients. Sarcopenia exhibited an increased risk of treatment failure (OR = 2.00, 95 % CI: 1.43-2.79) and notably increased the need for surgery (OR = 1.54, 95 % CI: 1.06-2.23) as opposed to a pharmacologic treatment plan change (OR = 1.19, 95 % CI: 0.71-2.01) among IBD patients. However, no significant association was found between sarcopenia and treatment failure in corticosteroid (OR = 1.21, 95 % CI: 0.55-2.64) or biologic agent (OR = 1.65, 95 % CI: 0.93-2.92) cohorts. Sarcopenia was also linked to elevated treatment failure risks in patients with Crohn’s disease (OR = 1.82, 95 % CI:1.15-2.90) and those diagnosed with ulcerative colitis (OR = 2.55, 95 % CI: 1.05-6.21), spanning both Asian (OR = 1.88, 95 % CI: 1.29-2.74) and non-Asian regions (OR = 2.17, 95 % CI: 1.48-3.18).
Conclusions: sarcopenia was considered as a novel marker for use in clinical practice to predict treatment failure, specifically, the need for surgery in IBD patients. This distinct cohort necessitates clinical attention and tailored care strategies.