Cited by 1,083Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromeAnorectal Disease Treatments and Outcomes

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Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease

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Ruemmele, F.M., Veres, G., Kolho, K.L., Griffiths, A., Levine, A., Escher, J.C., Amil Dias, J., Barabino, A., Braegger, C.P., Bronsky, J., Buderus, S., Martín-de-Carpi, J., De Ridder, L., Fagerberg, U.L., Hugot, J.P., Kierkus, J., Kolacek, S., Koletzko, S., Lionetti, P., Miele, E., Navas López, V.M., Paerregaard, A., Russell, R.K., Serban, D.E., Shaoul, R., Van Rheenen, P., Veereman, G., Weiss, B., Wilson, D., Dignass, A., Eliakim, A., Winter, H., Turner, D.·2014·Journal of Crohn s and Colitis

DOI 10.1016/j.crohns.2014.04.005

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Abstract

Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach. These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.

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Background
Dietary treatment of Crohn’s disease: perceptions of families with children treated by exclusive enteral nutrition, a questionnaire survey
Svolos, V., Gerasimidis, K., Buchanan, E., Curtis, L., Garrick, V., Hay, J., Laird, S., Munro, J. I., Gaya, D. R., Russell, R. K., et al. (2017) · BMC Gastroenterology · doi:10.1186/s12876-016-0564-7 · Cited by 48
“EEN induces both mucosal and transmural healing, has up to 80% remission rates and an excellent safety profile [3].”
Background
Enfermedad de Crohn
Ballester, M. P., Boscá-Watts, M. M., & Pérez, M. M. (2017) · Medicina Clínica · doi:10.1016/j.medcli.2017.10.036 · Cited by 48
Gut dysbiosis and paediatric Crohn's disease
Brusaferro, A., Cavalli, E., Farinelli, E., Cozzali, R., Principi, N., & Esposito, S. (2018) · Journal of Infection · doi:10.1016/j.jinf.2018.10.005 · Cited by 48
Ustekinumab in Pediatric Crohn Disease Patients
Bishop, C., Simon, H., Suskind, D. L., Lee, D. Y., & Wahbeh, G. T. (2016) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001146 · Cited by 47
“he majority of children and adolescents with Crohn disease receive nutritional therapy (1), corticosteroids, azathioprine/ T 6-mercaptopurine, methotrexate, infliximab, and adalimumab to induce and maintain remission.”
Background
Vedolizumab use after failure of TNF-α antagonists in children and adolescents with inflammatory bowel disease
Schneider, A.-M., Weghuber, D., Hetzer, B., Entenmann, A., Müller, T., Zimmermann, G., Schütz, S., Huber, W., & Pichler, J. (2018) · BMC Gastroenterology · doi:10.1186/s12876-018-0868-x · Cited by 47
Fracture Risk in Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study From 1964 to 2014
Ludvigsson, J. F., Måhl, M., Sachs, M. C., Björk, J. A., Michaëlsson, K., Ekbom, A., Askling, J., Backman, A.-S., & Olén, O. (2019) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000062 · Cited by 48
Dietary Strategies for Maintenance of Clinical Remission in Inflammatory Bowel Diseases: Are We There Yet?
Gkikas, K., Gerasimidis, K., Milling, S. W. F., Ijaz, U. Z., Hansen, R., & Russell, R. K. (2020) · Nutrients · doi:10.3390/nu12072018 · Cited by 47
“EEN consists of the exclusive consumption of a proprietary formula, typically for 6–8 weeks, and is the first-line treatment for induction of remission in mild and moderate pediatric CD across Europe, Canada and Oceania [17,18].”
Background
Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU
Chaparro, M., Garre, A., Ricart, E., Iglesias-Flores, E. M., Taxonera, C., Domènech, E., Gisbert, J. P., & ENEIDA study group (2019) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.15114 · Cited by 46
Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift
Caro, S. D., Fragkos, K. C., Keetarut, K., Koo, H. F., Sebepos‐Rogers, G., Saravanapavan, H., Barragry, J., Rogers, J. P., Mehta, S. J., & Rahman, F. Z. (2019) · Nutrients · doi:10.3390/nu11092222 · Cited by 47
“European Crohn’s and Colitis Organisation (ECCO)/European Society for Paediatric Gastroenterology Hepatology and Nutrition(ESPGHAN) 2014 [120] A set of evidenced based and consensus driven guidelines for paediatric-onset CD formulated by an expert panel of 33 IBD specialists to optimise treatment of children and adole…”
Background
Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on the use of thiopurines in inflammatory bowel disease.
Bermejo, F., Aguas, M., Chaparro, M., Domènech, E., Echarri, A., García-Planella, E., Guerra, I., Gisbert, J. P., & López–Sanromán, A. (2018) · PubMed · doi:10.1016/j.gastrohep.2017.11.007 · Cited by 45
Nutrition in Pediatric Inflammatory Bowel Disease: From Etiology to Treatment. A Systematic Review
Penagini, F., Dilillo, D., Borsani, B., Cococcioni, L., Galli, E., Bedogni, G., Zuin, G., & Zuccotti, G. (2016) · Nutrients · doi:10.3390/nu8060334 · Cited by 46
Use of Placebo in Pediatric Inflammatory Bowel Diseases
Turner, D., Koletzko, S., Griffiths, A. M., Hyams, J. S., Dubinsky, M. C., de Ridder, L., Escher, J. C., Lionetti, P., Cucchiara, S., Lentze, M. J., et al. (2015) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001024 · Cited by 45
“Withholding treatment deviates from accepted clinical practice and standard of care, as recommended in the present pediatric guidelines of managing UC and CD (5,6).”
BackgroundMethod
NASPGHAN Clinical Report
Ardura, M. I., Toussi, S. S., Siegel, J. D., Lu, Y., Bousvaros, A., & Crandall, W. (2016) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001188 · Cited by 45
The prevalence of irritable bowel syndrome‐type symptoms in paediatric inflammatory bowel disease, and the relationship with biochemical markers of disease activity
Diederen, K., Hoekman, D. R., Hummel, T., de Meij, T. G. J., Koot, B. G. P., Tabbers, M. M., Vlieger, A. M., Kindermann, A., & Benninga, M. A. (2016) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13636 · Cited by 46
“Current guidelines suggest monitoring of biomarkers to determine resolution or recurrence of intestinal inflammation, but the cut-off value that should trigger changes in management is still elusive.(22) Elevated faecal calprotectin levels have been shown to be associated with persistent endoscopic inflammation and an…”
Background
Exclusive enteral nutrition: An optimal care pathway for use in adult patients with active Crohn's disease
Day, A. S., Wood, J. A., Melton, S. L., & Bryant, R. V. (2019) · JGH Open · doi:10.1002/jgh3.12256 · Cited by 45
Paediatric onset inflammatory bowel disease is a distinct and aggressive phenotype—a comparative population‐based study
Malham, M., Jakobsen, C., Vester-Andersen, M. K., Lo, B. Z. S., Pærregaard, A., Vind, I., & Wewer, V. (2019) · GastroHep · doi:10.1002/ygh2.368 · Cited by 44
Partial enteral nutrition induces clinical and endoscopic remission in active pediatric Crohn’s disease: results of a prospective cohort study
Urlep, D., Benedik, E., Brecelj, J., & Orel, R. (2019) · European Journal of Pediatrics · doi:10.1007/s00431-019-03520-7 · Cited by 44
Association Between Steroid-Sparing Therapy and the Risk of Perianal Fistulizing Complications Among Young Patients With Crohn Disease
Adler, J., Lin, C. C., Gadepalli, S. K., & Dombkowski, K. J. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.7378 · Cited by 44
Diet and Nutrition in Pediatric Inflammatory Bowel Diseases
Cucinotta, U., Romano, C., & Dipasquale, V. (2021) · Nutrients · doi:10.3390/nu13020655 · Cited by 43
“9%) than described so far in other trials evaluating PEN [34,40].”
Background
Adolescent transition clinic in inflammatory bowel disease: quantitative assessment of self-efficacy skills
Yerushalmy‐Feler, A., Ron, Y., Barnea, E., Nachum, A., Matalon, S., Dali‐Levy, M., Dotan, I., & Cohen, S. (2017) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000864 · Cited by 43
Treating children with inflammatory bowel disease: Current and new perspectives
Guariso, G., & Gasparetto, M. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i30.5469 · Cited by 43
An overview of the role of exclusive enteral nutrition for complicated Crohn’s disease
Adamji, M., & Day, A. S. (2018) · Intestinal Research · doi:10.5217/ir.2018.00079 · Cited by 43
“Consequently, EEN is now recommended in international guidelines as the first line of therapy for children or adolescents with active CD.(3,6,7) However, EEN may also have roles beyond those described solely for inflammatory luminal CD.”
Background
Adequate Infliximab Exposure During Induction Predicts Remission in Paediatric Patients With Inflammatory Bowel Disease
van Hoeve, K., Dreesen, E., Hoffman, I. E. A., Assche, G. V., Ferrante, M., Gils, A., & Vermeire, S. (2019) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002265 · Cited by 43
Complications and Disease Recurrence After Primary Ileocecal Resection in Pediatric Crohnʼs Disease
Diederen, K., de Ridder, L., van Rheenen, P., Wolters, V. M., Mearin, M. L., Damen, G. M., de Meij, T. G. J., van Wering, H. M., Tseng, L. A., Oomen, M. W., et al. (2017) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000999 · Cited by 42
Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis
Lunken, G., Tsai, K., Schick, A., Lisko, D. J., Cook, L. E., Vallance, B. A., & Jacobson, K. (2021) · Cellular and Molecular Gastroenterology and Hepatology · doi:10.1016/j.jcmgh.2021.06.011 · Cited by 42
“011 plete liquid diet with no food intake, is considered the gold standard treatment for inducing disease remission in newly diagnosed pediatric CD patients.(2,3) It provides comparable benefits over standard medications (ie, corticosteroids and 5-aminosalicylates agents) but also promotes mucosal healing and improved…”
Background
Management of paediatric ulcerative colitis, part 1: Ambulatory care—An updated evidence‐based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organisation
Wine, E., Aloi, M., Biervliet, S. V., Bronský, J., de Carpi, J. M., Gasparetto, M., Gianolio, L., Gordon, H., Hojsak, I., Hudson, A. S., et al. (2025) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70097 · Cited by 52
Management of Crohn's disease
Kammermeier, J., Morris, M.-A. C., Garrick, V., Furman, M. A., Rodrigues, A., Russell, R. K., & BSPGHAN IBD Working Group (2015) · Archives of Disease in Childhood · doi:10.1136/archdischild-2014-307217 · Cited by 41
16S sequencing and functional analysis of the fecal microbiome during treatment of newly diagnosed pediatric inflammatory bowel disease
Ashton, J. J., Colquhoun, C. M., Cleary, D. W., Coelho, T. A. F., Haggarty, R., Mulder, I. E., Batra, A., Afzal, N. A., Beattie, R. M., Scott, K. P., et al. (2017) · Medicine · doi:10.1097/md.0000000000007347 · Cited by 41
Efficacy and safety of infliximab in very early onset inflammatory bowel disease: a national comparative retrospective study
Bramuzzo, M., Arrigo, S., Romano, C., Filardi, M. C., Lionetti, P., Agrusti, A., Dipasquale, V., Paci, M., Zuin, G., Aloi, M., et al. (2019) · United European Gastroenterology Journal · doi:10.1177/2050640619847592 · Cited by 41
Perianal Crohn’s Disease Is Associated With Poor Disease Outcome: A Nationwide Study From the epiIIRN Cohort
Atia, O., Asayag, N., Focht, G., Lujan, R., Ledder, O., Greenfeld, S., Kariv, R., Dotan, I., Gabay, H., Balicer, R. D., et al. (2021) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.04.007 · Cited by 41
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Szajewska, H., Konarska, Z., & Kołodziej, M. (2016) · Digestive Diseases · doi:10.1159/000443359 · Cited by 43
Therapeutic Drug Monitoring in Pediatric Inflammatory Bowel Disease
Carman, N., Mack, D. R., & Benchimol, E. I. (2018) · Current Gastroenterology Reports · doi:10.1007/s11894-018-0623-z · Cited by 40
Clinical Aspects and Treatments for Pediatric Inflammatory Bowel Diseases
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“ianal disease, can be recommended to reduce bowel damage [27].”
BackgroundInfluential
The Characteristics and Long-term Outcomes of Pediatric Crohnʼs Disease Patients with Perianal Disease
Herman, Y., Rinawi, F., Rothschild, B., Nir, O., Shamir, R., & Assa, A. (2017) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000001171 · Cited by 39
How to predict response to anti-tumour necrosis factor agents in inflammatory bowel disease
Naviglio, S., Giuffrida, P., Stocco, G., Lenti, M. V., Ventura, A., Corazza, G. R., & Sabatino, A. D. (2018) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2018.1494573 · Cited by 40
Intensified Infliximab Induction is Associated with Improved Response and Decreased Colectomy in Steroid-Refractory Paediatric Ulcerative Colitis
Church, P. C., Ho, S. S. C., Sharma, A., Tomalty, D., Frost, K., Muise, A. M., Walters, T. D., & Griffiths, A. M. (2019) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjz019 · Cited by 39
Towards a Food Pharmacy: Immunologic Modulation through Diet
Molendijk, I., van der Marel, S., & Maljaars, J. (2019) · Nutrients · doi:10.3390/nu11061239 · Cited by 42
“EEN is currently the first-line treatment to induce remission in children with active CD [20,21].”
Background
Quality of Life in Children and Adolescents with Inflammatory Bowel Disease: Impact and Predictive Factors
Silva, L. C., Seixas, R. B. P. D. M., & de Carvalho, E. (2020) · Pediatric Gastroenterology Hepatology & Nutrition · doi:10.5223/pghn.2020.23.3.286 · Cited by 39
“…count >450,000 per microliter, to assess thrombocytosis), erythrocyte sedimentation rate and C-reactive protein levels, and albumin level (albumin level <3.5 g/dL, to assess hypoalbuminemia); and therapeutics (drugs and surgery), which followed previously published recommendations [17,18].”
Influential
Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission
Diederen, K., Hoekman, D. R., Leek, A., Wolters, V. M., Hummel, T., de Meij, T. G. J., Koot, B. G. P., Tabbers, M. M., Benninga, M. A., & Kindermann, A. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13950 · Cited by 38
Nutritional support in paediatric Crohn's disease: outcome at 12 months
Gavin, J., Ashton, J. J., Heather, N., Marino, L. V., & Beattie, R. M. (2017) · Acta Paediatrica · doi:10.1111/apa.14075 · Cited by 38
“All patients were diagnosed as per modified Porto criteria (17) and treated according to standard protocol as per ESPGHAN/ECCO (6,7).”
BackgroundMethod
Development and Testing of a New Simplified Endoscopic Mucosal Assessment for Crohn’s Disease: The SEMA-CD
Adler, J., Eder, S. J., Gebremariam, A., French, K., Moncion, I., Singer, A. A. M., Bass, L. M., Moran, C. J., Picoraro, J. A., Moses, J., et al. (2020) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izaa307 · Cited by 38
Paediatric Inflammatory Bowel Disease and its Relationship with the Microbiome
Fitzgerald, R. S., Sanderson, I. R., & Claesson, M. J. (2021) · Microbial Ecology · doi:10.1007/s00248-021-01697-9 · Cited by 39
Use of Anti-TNFα Agents and Time to First-time Surgery in Paediatric Patients with Ulcerative Colitis and Crohn’s Disease
Larsen, M. D., Qvist, N., Nielsen, J., Kjeldsen, J., Nielsen, R. G., & Nørgård, B. M. (2016) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjw017 · Cited by 37
Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease
Wei, S., Chang, T., Chao, T., Chen, J., Chou, J., Chou, Y.-H., Chuang, C., Hsu, W., Huang, T., Hsu, T., et al. (2017) · Intestinal Research · doi:10.5217/ir.2017.15.3.285 · Cited by 37
“6 mg/kg (maximum 40 mg) every other week.(197)”
BackgroundInfluential
Inflammatory bowel disease in chronic granulomatous disease: An emerging problem over a twenty years' experience
Angelino, G., Angelis, P. D., Faraci, S., Rea, F., Romeo, E. F., Torroni, F., Tambucci, R., Claps, A., Francalanci, P., Chiriaco, M., et al. (2017) · Pediatric Allergy and Immunology · doi:10.1111/pai.12814 · Cited by 37
Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?
Serban, D. E. (2018) · World Journal of Clinical Cases · doi:10.12998/wjcc.v6.i12.501 · Cited by 37
Oral exclusive enteral nutrition induces mucosal and transmural healing in patients with Crohn’s disease
Chen, J.-M., He, L., Yan, T., Guo, X.-F., Hu, P., Peng, J., Cheng, W., Li, L.-L., & He, Q. (2019) · Gastroenterology report · doi:10.1093/gastro/goy050 · Cited by 37
Inflammatory Bowel Disease in Children and Adolescents
Rubalcava, N. S., & Gadepalli, S. K. (2021) · Advances in Pediatrics · doi:10.1016/j.yapd.2021.05.005 · Cited by 37
Dietary Intake and Systemic Inflammation: Can We Use Food as Medicine?
Graff, E., Vedantam, S., Parianos, M., Khakoo, N. S., Beiling, M., & Pearlman, M. Y. (2023) · Current Nutrition Reports · doi:10.1007/s13668-023-00458-z · Cited by 40

Authors: Ruemmele, F. M., Veres, G., Kolho, K. L., Griffiths, A., Levine, A., Escher, J. C., Amil Dias, J., Barabino, A., Braegger, C. P., Bronsky, J., Buderus, S., Martín-de-Carpi, J., De Ridder, L., Fagerberg, U. L., Hugot, J. P., Kierkus, J., Kolacek, S., Koletzko, S., Lionetti, P., Miele, E., Navas López, V. M., Paerregaard, A., Russell, R. K., Serban, D. E., Shaoul, R., Van Rheenen, P., Veereman, G., Weiss, B., Wilson, D., Dignass, A., Eliakim, A., Winter, H., & Turner, D.
Affiliations: Hôpital Necker-Enfants Malades (FR)
Semmelweis University (HU)
Helsinki University Hospital (FI)
University of Toronto (CA)
Tel Aviv University (IL)
Erasmus MC (NL)
Unit of Paediatric Gastroenterology, Hospital S. João, A Hernani Monteiro, 4202-451, Porto, Portugal
Istituto Giannina Gaslini (IT)
University Children's Hospital Zurich (CH)
Department of Pediatrics, University Hospital Motol, Uvalu 84, 150 06 Prague, Czech Republic
St. Marien-Hospital Bonn (DE)
Department of Paediatric Gastroenterolgoy, Hepatology and Nutrition, Hospital Sant Joan de Déu, Paseo Sant Joan de Déu 2, 08950 Barcelona, Spain
Department of Paediatric Gastroenterology, Erasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, Netherlands
Karolinska Institutet (SE)
Sorbonne Paris Cité (FR)
Department of Gastroenterology, Hepatology and Feeding Disorders, Instytut Pomnik Centrum Zdrowia Dziecka, Ul. Dzieci Polskich 20, 04-730 Warsaw, Poland
Department of Paediatric Gastroenterology, Children's Hospital, University of Zagreb Medical School, Klaićeva 16, 10000 Zagreb, Croatia
Department of Paediatric Gastroenterology, Dr. von Hauner Children's Hospital, Lindwurmstr. 4, 80337 Munich, Germany
Meyer Children's Hospital (IT)
University of Naples Federico II (IT)
Paediatric Gastroenterology and Nutrition Unit, Hospital Materno Infantil, Avda. Arroyo de los Ángeles s/n, 29009 Málaga, Spain
Department of Paediatrics 460, Hvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark
Department of Paediatric Gastroenterology, Yorkhill Hospital, Dalnair Street, Glasgow G3 8SJ, United Kingdom
Iuliu Hațieganu University of Medicine and Pharmacy (RO)
Rambam Health Care Campus (IL)
Department of Paediatric Gastroenterology, Hepatology and Nutrition, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, Netherlands
Queen Fabiola Children's University Hospital (BE)
Sheba Medical Center (IL)
Royal Hospital for Sick Children (GB)
Agaplesion Markus Hospital (DE)
Massachusetts General Hospital (US)
Hebrew University of Jerusalem (IL)
Corresponding author: Ruemmele, F.M.
ORCID: Ruemmele, F.M.
Veres, G.
Kolho, K.L.
Griffiths, A.
Levine, A.
Escher, J.C.
Braegger, C.P.
Buderus, S.
Fagerberg, U.L.
Hugot, J.P.
Koletzko, S.
Lionetti, P.
Miele, E.
Russell, R.K.
Serban, D.E.
Shaoul, R.
Veereman, G.
Weiss, B.
Wilson, D.
Dignass, A.
Winter, H.
Turner, D.
Venue: Journal of Crohn s and Colitis
Publisher: Oxford University Press (OUP)
Published: 2014-10-01
Volume: 8
Issue: 10
Pages: 1179-1207
ISSN: 1873-9946 (ISSN-L)
1876-4479
DOI: 10.1016/j.crohns.2014.04.005
OpenAlex: W2135936774
Cited by: 1,083
References: 293
Citations by year: 2026: 61 · 2025: 60 · 2024: 71 · 2023: 97 · 2022: 83 · 2021: 123 · 2020: 117 · 2019: 136 · 2018: 92 · 2017: 122 · 2016: 61 · 2015: 52 · 2014: 5
FWCI: 52.41
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Crohn s and Colitis (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, other-oa)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
BOA (University of Milano-Bicocca) (submittedVersion, cc-by-nc-nd)
Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion)
Florence Research (University of Florence) (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
VUBIR (Vrije Universiteit Brussel) (submittedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Zurich Open Repository and Archive (University of Zurich)
Topics: Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
Health Sciences › Medicine › Surgery › Anorectal Disease Treatments and Outcomes
Keywords: pediatric Crohn's disease, medical management
MeSH terms: Adalimumab, Infliximab, Adolescent, Adrenal Cortex Hormones, Algorithms, Aminosalicylic Acids, Anti-Inflammatory Agents, Non-Steroidal, Anti-Bacterial Agents, Antibodies, Monoclonal, Azathioprine, Child, Crohn Disease, Enteral Nutrition, Humans, Immunosuppressive Agents, Methotrexate, Remission Induction, Thalidomide, Tumor Necrosis Factor-alpha, Mercaptopurine, Maintenance Chemotherapy, Antibodies, Monoclonal, Humanized

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Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease

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