Medical Management of Pediatric Inflammatory Bowel Disease (PIBD) in the Asia Pacific Region: A Position Paper by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Journal
Journal of gastroenterology and hepatology
Journal Volume
38
Journal Issue
4
Pages
523
Date Issued
2022-12-27
Author(s)
Lee, Way Seah
Arai, Katsuhiro
Alex, George
Treepongkaruna, Suporn
Kim, Kyung Mo
Choong, Chee Liang
Mercado, Karen Sc
Darma, Andy
Srivastava, Anshu
Aw, Marion M
Huang, James
Malik, Rohan
Tanpowpong, Pornthep
Tran, Hong Ngoc
Ukarapol, Nuthapong
Abstract
Pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialised 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. Conclusion: This position paper provides a useful guide to clinicians in the medical management of children with PIBD in the Asia Pacific region.
Subjects
Asia Pacific region; Nudix Hydrolase 15; Pediatric inflammatory bowel disease; gastrointestinal infections; resource limited
SDGs
Publisher
WILEY
Type
review