Epidemiology and Long-term Outcome of Inflammatory Bowel Disease Diagnosed at Elderly Age—An Increasing Distinct Entity?

Jeuring, Steven; Heuvel, Tim R A van den; Zeegers, Maurice P.; Hameeteman, Wim; Romberg‐Camps, Mariëlle; Oostenbrug, Liekele E.; Masclee, Ad; Jonkers, Daisy; Pierik, Marieke

doi:10.1097/mib.0000000000000738

Cited by 151 publications

(189 citation statements)

References 56 publications

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“…The numbers of individuals with ulcerative colitis (UC) have been increasing in recent years in many countries. The numbers of elderly UC patients in particular are increasing in part because individuals who have chronic UC eventually grow old with their disease, and elderly persons also newly develop UC . However, few clinical trials have been performed in elderly UC patients, and their clinical characteristics, responses to treatment, and adverse effects profile are not sufficiently well defined.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of granulocyte adsorption apheresis in elderly patients with ulcerative colitis

Ito

Omori

Hanafusa

et al. 2018

J of Clinical Apheresis

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of granulocyte adsorption apheresis in elderly patients with ulcerative colitis

Ito

Omori

Hanafusa

et al. 2018

J of Clinical Apheresis

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“…UC can develop at any age and is more common in young adults, but more than 25% (up to 35%) of those with IBD are older than 60 years of age . In this study, 23.0% of the population with moderate to severe active UC was older than 60 years of age.…”

Section: Discussionmentioning

confidence: 56%

Single‐Needle Intensive Granulocyte and Monocyte Adsorptive Apheresis Is Suitable for Elderly Patients With Active Ulcerative Colitis Taking no Corticosteroids or Biologics

Fukuchi¹,

Koga²,

Kaichi³

et al. 2019

Ther Apher Dial

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Twice‐weekly intensive granulocyte/monocyte adsorptive apheresis is effective and safe for ulcerative colitis, but maintaining two blood access routes is problematic. We previously reported that intensive granulocyte/monocyte adsorptive apheresis using a single needle in ulcerative colitis is effective and safe. We hypothesized that the efficacy and safety of single‐needle intensive granulocyte/monocyte adsorptive apheresis for ulcerative colitis would especially benefit the elderly. We enrolled 17 elderly ulcerative colitis patients to receive single‐needle intensive granulocyte/monocyte adsorptive apheresis, 27 elderly ulcerative colitis patients to receive double‐needle intensive granulocyte/monocyte adsorptive apheresis, and 52 nonelderly ulcerative colitis patients to receive single‐needle intensive granulocyte/monocyte adsorptive apheresis. Remission and mucosal healing rates after treatment did not differ significantly between elderly ulcerative colitis patients receiving single‐needle apheresis and the other two groups. In addition, no serious adverse effects, including blood clots, were observed in single‐needle intensive granulocyte/monocyte adsorptive apheresis patients. Single‐needle intensive granulocyte/monocyte adsorptive apheresis might be a novel alternative therapeutic option for elderly ulcerative colitis patients before considering corticosteroids.

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“…5, 11 . In common with these studies, we also report that patients diagnosed with Crohn's disease at an older age have less ileo-colonic disease.…”

Section: Discussionmentioning

confidence: 99%

“…It is widely known that the United States population is aging 3 . Therefore, the number of people with a new diagnosis of IBD at older ages will increase, as will the number of younger IBD patients become old 2, 4, 5 .…”

Section: Introductionmentioning

confidence: 99%

“…We require a thorough understanding of how the disease process differs in older adults in order to best balance co-morbidities, polypharmacy and use of resources in treating older patients with IBD 6 . Prior reports of IBD in older adults have often focused on those who are newly-diagnosed at an older age; less is known about how IBD evolves with age as patients with IBD survive longer 5, 7-11 . There is also a need to understand how IBD differs between those who age with the disease and those who are newly diagnosed at an older age.…”

Section: Introductionmentioning

confidence: 99%

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Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset

Kochar

Long

Galanko

et al. 2017

Inflammatory Bowel Diseases

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Background As the American population is aging, the number of older people with IBD is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. Methods We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate and multivariate analyses. “Older-onset” patients were diagnosed after age 60, “younger-onset” patients were diagnosed before age 60, but are older than 60 years and the remainder were “young”. Results There were 91 older-onset, 389 younger-onset and 3431 young Crohn's disease (CD) patients. Older-onset patients had more ileal (37%) and colonic (27%) disease compared to younger-onset and young patients. There were no differences in disease behavior, location or surgeries between older-onset and young CD patients within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-TNF and thiopurine use compared to younger-onset and older-onset patients (p <0.01). There were 98 older-onset, 218 younger-onset and 1702 young ulcerative colitis (UC) patients. There were no differences in disease extent, activity index or surgeries. Young UC patients reported more anti-TNF use (26%) compared to younger-onset patients (17%, p <0.01). Conclusions Disease behavior or location were not different between younger and older adults with IBD. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk sub-optimally controlled disease.

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Epidemiology and Long-term Outcome of Inflammatory Bowel Disease Diagnosed at Elderly Age—An Increasing Distinct Entity?

Abstract: EO IBD is rising, warranting physicians' alertness for IBD in elderly patients. The long-term outcome was not different from AO disease, despite a less frequent use of immunomodulators and biologicals.

Cited by 151 publications

References 56 publications

Efficacy and safety of granulocyte adsorption apheresis in elderly patients with ulcerative colitis

Efficacy and safety of granulocyte adsorption apheresis in elderly patients with ulcerative colitis

Single‐Needle Intensive Granulocyte and Monocyte Adsorptive Apheresis Is Suitable for Elderly Patients With Active Ulcerative Colitis Taking no Corticosteroids or Biologics

Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset

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