Eficácia e segurança dos imunossupressores no tratamento das Doenças Inflamatórias Intestinais em crianças: uma revisão sistemática

Abstract

Inflammatory bowel diseases are chronic inflammatory disorders that affect the gastrointestinal tract. In pediatric patients, about 25%, the disease has a more aggressive nature and a worse prognosis. In addition, they reach them at an important stage of their development, generating significant physical and cognitive deficit. Treatment, when instituted effectively and rapidly, alters the natural history of the disease and prevents its complications. Immunomodulators (azathioprine and methotrexate) are used as first choice in the maintenance of the disease, however, the scientific basis for the management of these drugs comes from studies in adults, and the efficacy and safety of these drugs in pediatric patients remains uncertain. This systematic review aims to systematically evaluate published studies on the efficacy and safety of immunomodulators for the treatment of inflammatory bowel diseases in children. A systematic search was performed in the PUBMED/MEDLINE and BVS/Lilacs databases, with search terms and Boolean operators: ((Inflammatory Bowel Disease) AND (Immunosuppressants OR Azathioprine OR Methotrexate). We included 12 articles with a total population of 1233 patients. Azathioprine and methotrexate have been shown to be safe and effective for the treatment of IBD in children and are recommended for moderate to severe disease, and individual prescription should be assessed.