Paediatric Crohn's disease in Belgium: phenotype at diagnosis and after three years follow-up: The BELCRO cohort

The Belgian Registry for paediatric Crohn’s disease (BELCRO) recruitednewly diagnosed and previously diagnosed paediatric Crohn’s Disease (CD)patients (2008-20010) and followed them for 5 years. The aim was to evaluate disease presentation, evolution, treatment and outcome such as disease activity and growth. A close collaboration with adult gastroenterologists assured an optimal paediatric patient recruitment and allowed comparison between paediatric and adult CD related medical care.This PhD thesis presents the main results of the BELCRO analysis at diagnosis and until 3 year follow-up. Disease presentation and age at diagnosis are similar to the surrounding countries. We notice a gooddisease control with the actual treatment paradigms and we were not able to identify clinical predictors for disease diagnosis, growth or disease activity during follow-up, except for the type of physician following thepatient: paediatric patients under adult care had worse disease activity at 3 year follow-up. As far as we know, adult and paediatric practices for paediatric CD have never been compared before. With the analysisperformed, we were unable to identify why the type of physician is theonly significant predictor, but we emit several hypothesis. This issue is worth investigating during further follow-up, notably after five yrs. We also notice that a >60% of our population is treated with biologicals at 3 yearfollow-up. Practices in biological administration, concomitant medication,safety and cost were evaluated for BELCRO patients.BELCRO pictures the status of actual medical care in paediatric CD inBelgium, but not all disease related factors could be part of our analysis.Elaboration of this project could certainly broaden the knowledge on paediatric CD. The results of this project suggest that new concepts suchas mucosal healing, drug levels, patient reported outcomes, …should bepart of a larger registration. BELCRO is just a beginning….