Medical management of pediatric inflammatory bowel disease in the Asia-Pacific region: A position paper by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Document Type
Article
Publication Date
4-1-2023
Abstract
Pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialized and affluent areas in the Asia-Pacific region. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in this region due to differences in disease characteristics and regional resources constraints. This position paper is an initiative from the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) with the aim of providing an up-to-date, evidence-based approach to PIBD in the Asia-Pacific region, taking into consideration the unique disease characteristics and financial resources available in this region. A group of pediatric gastroenterologists with special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management, and monitoring. Gastrointestinal infections, including tuberculosis, need to be excluded before diagnosing IBD. In some populations in Asia, the Nudix Hydrolase 15 (NUD15) gene is a better predictor of leukopenia induced by azathioprine than thiopurine-S-methyltransferase (TPMT). The main considerations in the use of biologics in the Asia-Pacific region are high cost, ease of access, and potential infectious risk, especially tuberculosis. This position paper provides a useful guide to clinicians in the medical management of children with PIBD in the Asia-Pacific region.
Keywords
Asia-Pacific region, Gastrointestinal infections, Nudix Hydrolase 15, Pediatric inflammatory bowel disease, Resource limited
Divisions
paediatrics
Funders
APPSPGHAN,Department of Pediatric Gastroenterology and Hepatology, Faculty of Medicine, Chiang Mai University,Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation,National Taiwan University College of Medicine, Taiwan Rohan Malik,Department of Pediatrics, University of Florida,BC Children's Hospital,Mahidol University,All-India Institute of Medical Sciences,Jeju National University Hospital
Publication Title
Journal of Gastroenterology and Hepatology
Volume
38
Issue
4
Publisher
Blackwell Publishing
Publisher Location
111 RIVER ST, HOBOKEN 07030-5774, NJ USA