Has the need for hospitalisation of paediatric inflammatory bowel disease patients changed with the increased use of infliximab?

Background Use of the TNF-alpha blocking agent infliximab has become established in the management of moderate to severe paediatric inflammatory bowel disease comparable to use in adult patients. We aimed to study whether the need for hospitalisation of paediatric patients has decreased with the increased use of this therapeutic agent.

Methods We traced patients with paediatric onset inflammatory bowel disease (ICD-10 codes K50 and K51) treated at the university hospitals of Helsinki and Tampere between 2003 and 2016. The numbers of outpatient visits and admissions were counted.

Results In total, there were 1,237 patients with paediatric onset inflammatory bowel disease of whom 58% were managed in Helsinki and the rest in Tampere. In Helsinki, 27% of the patients received infliximab and its use increased during the study period. During this time period, the number of outpatient visits increased but the frequency of admissions did not change and in Helsinki the median number of days on the ward decreased.

Conclusions The use of infliximab has not resulted in fewer admissions of paediatric patients with inflammatory bowel disease. However, the proportion of patients admitted has decreased and the length of hospital stays may have shortened as well.