Su1857 – Comparative Safety and Effectiveness of Tumor Necrosis Factor Alpha Antagonists and Vedolizumab in Older IBD Patients: A Multicenter Study

Adar, Tomer; Faleck, David; Sasidharan, Saranya; Cushing, Kelly C.; Nalagatla, Niharika; Ungaro, Ryan C.; Sy, Wayne A.; Owen, Samuel; Patel, Anish; Cohen, Benjamin L.; Ananthakrishnan, Ashwin N.

doi:10.1016/s0016-5085(19)38494-x

Cited by 1 publication

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“…The existing literature on treatment efficacy and safety in older IBD patients comprises largely of retrospective studies assessing chronologic age without consideration of function, reserve, and vulnerability. [27][28][29] Frailty While there is no universally accepted definition of frailty, it is most often described as a complex, multi-dimensional syndrome that leads to increased vulnerability to stress and decline of reserve across multiple physiologic systems and thereby increases the risk of adverse health outcomes. 30 Frailty is associated with aging, yet is independent of age.…”

Section: Ibd and Agingmentioning

confidence: 99%

Frailty in inflammatory bowel diseases: an emerging concept

Kochar

Orkaby

Ananthakrishnan

et al. 2021

Therap Adv Gastroenterol

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Inflammatory bowel diseases (IBD), consisting of Crohn’s disease and ulcerative colitis, are chronic remitting, relapsing inflammatory conditions of the gastrointestinal tract. While traditionally a disease of younger ages, the number of older adults with IBD is rising rapidly. Patients with IBD often experience geriatric syndromes at earlier ages. Older adults with IBD have poorer disease and treatment-related outcomes compared with younger adults with IBD. Applying the principles of geriatrics to understanding a chronic disease in older adults may improve health span. Better tools are needed to stratify IBD patients who are at high risk for adverse events. Frailty is a geriatric construct that may approximate biologic age. Frailty is a complex, multi-dimensional syndrome that leads to increased vulnerability to stress and decline of reserve across multiple physiologic systems. In this review, we present the leading conceptual models of frailty and discuss the applications of frailty in immune-mediated diseases. We also review chronic conditions where frailty has been applied successfully as a tool for risk stratification. Finally, we discuss in the detail the growing body of literature highlighting the relationship between frailty and IBD, the epidemiology of frailty in IBD, and ramifications of frailty in IBD.

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