Paediatrics

Background and Aim:Approximately 10% of people with inflammatory bowel diseases (IBD) are diagnosed in childhood.Crohn's Colitis Care (CCCare) is an IBD-specific electronic medical record (EMR) used across Australia and New Zealand, with a recent upgrade to incorporate paediatric functionality.Using CCCare, we explored the real-world use of dietary and medical therapies across the age spectrum in people with IBD under routine ambulatory care in ANZ.Methods: De-identified data from CCCare's linked clinical quality registry were analysed in April 2024.All people with IBD under active care (clinical encounter within the prior 14 months) were included.Children were defined as being <18 years of age at time of extraction.Results: A total of 6,396 people with IBD were included.In the <18 years age group (n=172), 59.1% (n=101) were male with a median age of 15 years .The majority (93%, n=93) resided in Australia, and most had Crohn's disease (66.5%, n=113), with 16.8% of them having ever had a perianal fistula.In the 18 years age group (n=6,224), 49.1% (n=3,055) were male with a median age of 42 years (IQR 32-57).The majority (76.5%, n=4,761) resided in Australia, and over half had Crohn's disease (55.7%, n=113), with 15.9% having ever had a perianal fistula.Interestingly, 5-aminosalicylate use was more prevalent in adults than children (34% vs 27% respectively, P<0.05), whereas current immunomodulator use was less common in adults compared to children (29% vs 60% respectively, P<0.001).Current steroid use was 4% in both cohorts (P=0.26).Advanced therapy use by age group is shown below.Anti-TNF therapies (infliximab and adalimumab) were the predominant therapies in the paediatric cohort.Across the cohort, infliximab use decreased with age, whereas vedolizumab use increased with age.Dietary therapies were infrequently used/documented, with only 5/172 (2.9%) receiving dietary therapy in the paediatric cohort (Exclusive Enteral Nutrition [EEN]=4, Crohn's Disease Exclusion Diet [CDED]=1) and 49/6224 (0.8%) in the adult cohort (EEN=36, CDED=13) (p<0.001). Conclusion:This study demonstrates CCCare's ability to support clinical research across all ages in people with IBD.Here, some interesting insights into variation of usage of dietary and advanced therapies are revealed.Some of the differences in advanced therapy use can perhaps be explained by licensing and funding arrangements, but others are possibly related to concerns regarding drug safety with advanced age.CCCare can track therapy choice in a large real-world cohort in real time.Future work to match these data on therapeutic choices with outcomes, complications and costs will soon enable us to report on comparative value of treatment strategies.