PARENTS MAY HAVE ANXIETY, DEPRESSION YEARS INTO CHILD’S IBD Parents of children with inflammatory bowel diseases (IBD) were found to have increased symptoms of distress, continuing over the course of their child’s disease, according to research presented at the AIBD 2021 Annual Meeting. Previous research has identified a pattern of elevated symptoms of depression and anxiety among parents of children with IBD. This study aimed to better assess how these symptoms change over the disease course of IBD. Investigators from Children’s Hospital of Pittsburgh in the United States recruited parents (N=155) of children with IBD aged 2 to 17 years for this cross-sectional study. Stratified by diagnosis time (<6 months vs >1 year), parental distress was assessed using the Patient Reported Outcomes Measurement Information System Short Form v1.0Anxiety (PROMIS-ANX), Patient Health Questionnaire-8 (PHQ-8), and Impact of Event Scale Revised (IESR).The parents’ children were recently diagnosed (n=52) or had established IBD (n=103). Clinically elevated PROMIS-ANX scores were observed among 52% of the newly diagnosed cohort. There was no significant change in PROMIS-ANX scores during the transition from newly diagnosed to established disease (mean, 3.77 vs 3.74; P =.220). Depression scores were clinically elevated among 45% of the parents of newly diagnosed children. Similar to anxiety, the transition to established disease did not
affect depression scores (mean, 1.426 vs 1.346; P =.266). For IES-R, parents of children who were recently diagnosed were more distressed compared with the parents of children with established disease (mean, 2.03 vs 1.62; P =.017). Additional stratification of parents with children diagnosed <3 months (n=37) and >5 years (n=41) previously found no difference between cohorts for PROMIS-ANX (P =.371) or PHQ-8 (P =.605) scores but a significant change in IES-R scores (P =.0478). This study found that parents of children with IBD had clinically elevated anxiety and depression scores.There did not appear to be a temporal pattern to their anxiety or depression and scores remain elevated even years after their child’s diagnosis. For distress measured by IES-R scores, there did appear to be a temporal pattern with a reduction in concordance with time since diagnosis. Additional studies are needed to assess potential interventions to mitigate the negative impact on parents.
USTEKINUMAB THERAPY LINKED TO HIGHER RATES OF CD REMISSION Ustekinumab treatment was associated with a high rate of remission among patients with Crohn disease (CD) who had previously failed to respond to antitumor necrosis factor (TNF) therapy, according to data from a real-world study presented at the AIBD 2021 Annual Meeting. Ustekinumab, a monoclonal antibody against the interleukin (IL)-12/23 subunit p40, was approved for the treatment of moderate to severe CD and ulcerative colitis. Researchers from the University of Massachusetts Medical School retrospectively reviewed patient records in a cohort of 34 patients with CD who had failed at least 1 anti-TNF treatment before induction with ustekinumab; 59%
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and consumption of fish, unprocessed poultry, or unprocessed red meat. Researchers recommended a modified diet for patients with IBD that limits consumption of processed meat, whether alone or in combination with medication use.
The proportion of patients with fistulizing disease who achieved remission was 70%.
of patients were women and 50% had fistulizing disease. Clinical remission was achieved by 70.5% of patients.Among those in remission, 29% were also taking concomitant steroids or immunomodulators at the time of remission. This relatively high remission rate also was found among the subgroup of patients with fistulizing CD (70%). Among patients with data on C-reactive protein levels (70%), the average level prior to ustekinumab induction was 2.4, which trended downward to 1.98 (95% CI, -0.064 to 1.08; P =.079) after starting therapy.Among the patients with fecal calprotectin data (18%), mean fecal calprotectin levels prior to ustekinumab induction were 386. Like C-reactive protein, fecal calprotectin also trended downward after ustekinumab exposure (mean, 175; 95% CI, -106.25 to 528.46; P =.148). This study found that ustekinumab was associated with a high rate of remission, even for patients with fistulizing CD, among a difficult to treat population who had prior failed anti-TNF therapy. ■
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