Bharati Kochar1, Millie D Long, Joseph Galanko, Laura E Raffals, Ashwin Ananthakrishnan, Robert S Sandler. 1. *Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina; †Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; and ‡Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: As the American population is aging, the number of older people with inflammatory bowel disease 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 patients with Crohn's disease. Older-onset patients had more ileal (37%) and colonic (27%) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26%) compared with younger-onset patients (17%, P < 0.01). CONCLUSIONS: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.
BACKGROUND: As the American population is aging, the number of older people with inflammatory bowel disease 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 patients with Crohn's disease. Older-onset patients had more ileal (37%) and colonic (27%) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26%) compared with younger-onset patients (17%, P < 0.01). CONCLUSIONS: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.
Authors: Eric I Benchimol; Suzanne F Cook; Rune Erichsen; Millie D Long; Charles N Bernstein; Jenna Wong; Charlotte F Carroll; Trine Frøslev; Tim Sampson; Michael D Kappelman Journal: J Crohns Colitis Date: 2012-09-25 Impact factor: 9.071
Authors: Meenakshi Bewtra; Craig W Newcomb; Qufei Wu; Lang Chen; Fenglong Xie; Jason A Roy; Cary B Aarons; Mark T Osterman; Kimberly A Forde; Jeffrey R Curtis; James D Lewis Journal: Ann Intern Med Date: 2015-08-18 Impact factor: 25.391
Authors: Sophia L Johnson; Christie M Bartels; Mari Palta; Carolyn T Thorpe; Jennifer M Weiss; Maureen A Smith Journal: BMJ Open Date: 2015-09-07 Impact factor: 2.692