PhD Scientific Days 2025

Poster Session II. - W: Conservative Medicine

Association between Extraintestinal Manifestation and Intestinal Disease Severity in Pediatric IBD

Name of the presenter

Tímár Ágnes Eszter

Institute/workplace of the presenter

Heim Pál National Pediatric Institute and Centre for Translational Medicine, Semmelweis University

Authors

Ágnes Eszter Tímár^1,2, Márk Hernádfői^1,3, Kornélia Farkas⁴, Zoltán Sipos⁴, Zsolt Abonyi-Tóth^1,5, HUPIR group⁶, Katalin Eszter Müller^2,7

1: Centre for Translational Medicine, Semmelweis University
2: Heim Pál National Pediatric Institute
3: MRE Bethesda Childrens’ Hospital
4: Institute for Translational Medicine, University of Pécs
5: University of Veterinary Medicine
6: -
7: Semmelweis University Faculty of Health Sciences, Department of Family Care Methodology

Text of the abstract

Introduction: Extraintestinal manifestations (EIMs) are common in pediatric inflammatory
bowel disease (IBD), often impairing quality of life and complicating disease management.
Still, their prognostic significance remains unclear.
Aims: To assess whether the presence of EIMs at diagnosis is associated with a more severe
intestinal disease course in pediatric IBD.
Methods: A retrospective analysis was conducted using the Hungarian Pediatric IBD
Registry (HUPIR), including children diagnosed with Crohn’s disease (CD) or ulcerative
colitis (UC) between 2010 and 2020. Clinical outcomes-including relapses, steroid
dependency or refractoriness, need for biological therapy (BT), and surgery-were compared
between patients who had EIMs at diagnosis and those who did not develop any EIMs during
follow-up by using Kaplan-Meier and multivariable cox regression analyses.
Results: Of the 1,590 patients included in the study, EIMs at diagnosis were significantly
more common in CD than in UC (25.0% vs. 14.0%, p < 0.0001). Joint involvement was the
most frequent EIM, reported in 159 patients (51.5%).
In CD, relapse rates did not significantly differ between patients with and without EIMs (p =
0.290). However, the presence of EIMs was associated with an earlier onset of steroid
dependency and a need for biological therapy (p = 0.0047 and p = 0.00049, respectively).
Interestingly, multivariable Cox regression analysis revealed that patients without EIMs had a
3.2-fold higher hazard of requiring intestinal resection compared to those with EIMs (95%
CI: 1.572–6.472; p = 0.001).
In UC, EIMs were not significantly associated with relapse (p = 0.600), steroid dependency
(p = 0.890), or the need for biological therapy (p = 0.081). However, colectomy was more
frequent and occurred earlier in patients with EIMs (p = 0.032).
Conclusion: In summary, patients with CD who presented with EIM at diagnosis had an
increased risk of requiring BT, although they were less frequently subjected to surgical
interventions. In contrast for patients with UC, the presence of EIMs at diagnosis appeared to
increase the risk of both BT and colectomy.

Funding: Project No. 2023-2.1.2-KDP-2023-00016 has been implemented with the support
provided by the Ministry of Culture and Innovation of Hungary from the National Research,
Development and Innovation Fund, financed under the KDP-2023 funding scheme.