Reversibility of Frail Phenotype in Patients with Inflammatory Bowel Diseases

Abstract

It was recently reported that frailty status can negatively influence the clinical course of patients with inflammatory bowel diseases (IBDs). Our recent study demonstrated that 20% of patients with an IBD are frail, and disease activity increases the risk of frailty. In the present study, we prospectively monitored this subgroup of frail patients, assessed whether the frailty status was reversible, and analyzed factors associated with frailty reversibility. Of the sixty-four frail patients with IBD enrolled, five (8%) were lost during the follow-up period and one (2%) underwent a colectomy. Eleven out of the fifty-eight (19%) patients maintained a frail phenotype during a median follow-up of 8 months (range 6–19 months), and thirty-five (60%) and twelve (21%) became pre-frail or fit, respectively. A comparison of the 58 patients at baseline and at the end of the study showed that frail phenotype reversibility occurred more frequently in patients who achieved clinical remission. A multivariate analysis showed that the improvement of the frail phenotype was inversely correlated with the persistence of clinically active disease (OR:0.1; 95% CI: 0.02–0.8) and a history of extra-intestinal manifestations (OR:0.1; 95% CI: 0.01–0.6) and positively correlated with the use of biologics (OR: 21.7; 95% CI: 3.4–263). Data indicate that the frail phenotype is a reversible condition in most IBD patients, and such a change relies on the improvement in disease activity.

Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence

“…Multivariate analysis found that frailty was associated with clinically active disease (OR:0.1, 95% CI: 0.01–0.6), extraintestinal manifestations (OR:0.1, 95% CI: 0.02–0.8), and is inversely related to biological use (OR:21.7, 95% CI: 3.4–263). This suggests that therapy with biologics may have a role in the improvement of frailty status 22 . Another prospective cohort study in elderly IBD patients measured frailty by geriatric deficit assessment and found a direct relationship between the number of geriatric deficits with clinical (OR:2.192, 95% CI: 1.284–3.743), biochemical disease activity (OR:3.358, 95% CI: 1.936–5.825), and fecal calprotectin levels (OR: 2.721, 95% CI: 1.376–5.379).…”