Advanced therapies in inflammatory bowel disease: Special considerations

Williams, Astrid-Jane

doi:10.1111/jgh.15454

Cited by 1 publication

(1 citation statement)

References 25 publications

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“…However, age, polypharmacy, comorbidities, and risk of frailty complicate disease management. Therapeutic efficacy is thought to be similar between the elderly and younger persons with IBD, but one must balance the increased of risk of infection, potential drug interactions, and heightened risk of malignancy ( 15 ).…”

Section: Treatmentmentioning

confidence: 99%

The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations—IBD in Seniors

Shaffer,

Kuenzig,

Windsor

et al. 2023

Journal of the Canadian Association of Gastroenterology

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Approximately one out of every 88 seniors has inflammatory bowel disease (IBD), and this is expected to increase in the future. They are more likely to have left-sided disease in ulcerative colitis, and isolated colonic disease in Crohn’s disease; perianal disease is less common. Other common diagnoses in the elderly must also be considered when they initially present to a healthcare provider. Treatment of the elderly is similar to younger persons with IBD, though considerations of the increased risk of infections and malignancy must be considered when using immune modulating drugs. Whether anti-TNF therapies increase the risk of infections is not definitive, though newer biologics, including vedolizumab and ustekinumab, are thought to be safer with lower risk of adverse events. Polypharmacy and frailty are other considerations in the elderly when choosing a treatment, as frailty is associated with worse outcomes. Costs for IBD-related hospitalizations are higher in the elderly compared with younger persons. When elderly persons with IBD are cared for by a gastroenterologist, their outcomes tend to be better. However, as elderly persons with IBD continue to age, they may not have access to the same care as younger people with IBD due to deficiencies in their ability to use or access technology.

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Section: Treatmentmentioning

confidence: 99%