Phenotype and natural history of elderly onset inflammatory bowel disease: a multicentre, case‐control study. Issue 5 (25th January 2018)

• Record Type: Journal Article
• Authors: Mañosa, M.; Calafat, M.; de Francisco, R.; García, C.; Casanova, M. J.; Huelín, P.; Calvo, M.; Tosca, J.; Fernández‐Salazar, L.; Arajol, C.; Zabana, Y.; Bastida, G.; Hinojosa, J.; Márquez, L.; Barreiro‐de‐Acosta, M.; Calvet, X.; Monfort, D.; Gómez‐Garcia, M. R.; Rodríguez, E.; Huguet, J. M.; Rojas‐Feria, M.; Hervias, D.; Atienza, R.; Busquets, D.; Zapata, E.; Dueñas, C.; Charro, M.; Martínez‐Cerezo, F. J.; Plaza, R.; Vázquez, J. M.; Gisbert, J. P.; Cañete, F.; Cabré, E.; Domènech, E.;
• Other Names: Arajol Clàudia investigator.; Atienza Ramón investigator.; Barreiro‐de‐Acosta Manuel investigator.; Bastida Guillermo investigator.; Busquets David investigator.; Calafat Margalida investigator.; Calvet Xavier investigator.; Calvo Marta investigator.; Cabré Eduard investigator.; Cañete Fiorella investigator.; Casanova Mª José investigator.; Charro Mara investigator.; Dueñas Carmen investigator.; Domènech Eugeni investigator.; de Francisco Ruth investigator.; Fernández‐Salazar Luis investigator.; García Carmen investigator.; Gómez‐Garcia María Rosario investigator.; Hervias Daniel investigator.; Hinojosa Joaquín investigator.; Huelín Patricia investigator.; Huguet José Mª investigator.; Mañosa Míriam investigator.; Márquez Lucía investigator.; Martínez‐Cerezo Francisco J. investigator.; Monfort David investigator.; Gisbert Javier P. investigator.; Plaza Rocío investigator.; Rodríguez Esther investigator.; Rojas‐Feria María investigator.; Tosca Joan investigator.; Vázquez Juan M. investigator.; Zabana Yamile investigator.; Zapata Eva investigator.;
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 47:Issue 5(2018)
• Page Start: 605
• Page End: 614
• Publication Date: 2018-01-25
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.14494
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Onset during old age has been reported in upto 10% of total cases of inflammatory bowel disease (IBD). Aim: To evaluate phenotypic characteristics and the use of therapeutic resources in patients with elderly onset IBD. Methods: Case‐control study including all those patients diagnosed with IBD over the age of 60 years since 2000 who were followed‐up for >12 months, identified from the IBD databases. Elderly onset cases were compared with IBD patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of IBD (adult‐onset). Results: One thousand three hundred and seventy‐four elderly onset and 1374 adult‐onset cases were included (62% ulcerative colitis (UC), 38% Crohn's disease (CD)). Among UC patients, elderly onset cases had a lower proportion of extensive disease (33% vs 39%; P < 0.0001). In CD, elderly onset cases showed an increased rate of stenosing pattern (24% vs 13%; P < 0.0001) and exclusive colonic location (28% vs 16%; P < 0.0001), whereas penetrating pattern (12% vs 19%; P < 0.0001) was significantly less frequent. Regarding the use of therapeutic resources, there was a significantly lower use of corticosteroids ( P < 0.0001), immunosuppressants ( P < 0.0001) and anti‐TNFs agents ( P < 0.0001) in elderly onset cases. Regarding surgery, we found a significantly higher surgery rate among elderly onset UC cases (8.3% vs 5.1%; P < 0.009). Finally, elderly onset cases were characterised by a higher rate of hospitalisations (66% vs 49%; P < 0.0001) and neoplasms (14% vs 0.5%; P < 0.0001). Conclusions: Elderly onset IBD shows specific characteristics and they are managed differently, with a lower use of immunosuppressants and a higher rate of surgery in UC. Abstract : Linked Content This article is linked to Everhov et al and Mañosa and Domènech papers. To view these articles visithttps://doi.org/10.1111/apt.14598 andhttps://doi.org/10.1111/apt.14622 .