BACKGROUND: The older patient group with inflammatory bowel diseases (IBD) is particularly vulnerable to consequences of disease and therapy-related side effects but little is known about the best treatment options in this population. AIM: To compare safety and efficacy of tumor necrosis factor α antagonist (anti-TNF) or vedolizumab (VDZ) in patients with IBD >60 years of age. METHODS: This retrospective study included patients with Crohn's disease (CD) or ulcerative colitis (UC) initiating anti-TNF or VDZ therapy ≥60 years of age at three study sites. We examined occurrence of infection or malignancy within 1 year after therapy as our primary outcome. Our efficacy outcomes included clinical remission at 3, 6 and 12 months. Multivariable logistic regression models adjusting for relevant confounders estimated odds ratios (OR) and 95% confidence intervals. RESULTS: The study included 131 anti-TNF and 103 VDZ initiated patients (age range 60-88 years). Approximately half had CD. At 1 year, there were no significant differences in safety profile between the two therapeutic classes. Infections were observed in 20% of anti-TNF-treated and 17% of VDZ-treated patients (P = 0.54). Pneumonia was the most common infection in both groups. While more anti-TNF-treated CD patients were in remission at 3 months compared to VDZ (OR 2.82, 95% CI 1.18-6.76), this difference was not maintained at 6 and 12 months suggesting similar efficacy of both classes. CONCLUSIONS: Both anti-TNF and VDZ therapy were similarly effective and safe in elderly IBD patients.
BACKGROUND: The older patient group with inflammatory bowel diseases (IBD) is particularly vulnerable to consequences of disease and therapy-related side effects but little is known about the best treatment options in this population. AIM: To compare safety and efficacy of tumor necrosis factor α antagonist (anti-TNF) or vedolizumab (VDZ) in patients with IBD >60 years of age. METHODS: This retrospective study included patients with Crohn's disease (CD) or ulcerative colitis (UC) initiating anti-TNF or VDZ therapy ≥60 years of age at three study sites. We examined occurrence of infection or malignancy within 1 year after therapy as our primary outcome. Our efficacy outcomes included clinical remission at 3, 6 and 12 months. Multivariable logistic regression models adjusting for relevant confounders estimated odds ratios (OR) and 95% confidence intervals. RESULTS: The study included 131 anti-TNF and 103 VDZ initiated patients (age range 60-88 years). Approximately half had CD. At 1 year, there were no significant differences in safety profile between the two therapeutic classes. Infections were observed in 20% of anti-TNF-treated and 17% of VDZ-treated patients (P = 0.54). Pneumonia was the most common infection in both groups. While more anti-TNF-treated CDpatients were in remission at 3 months compared to VDZ (OR 2.82, 95% CI 1.18-6.76), this difference was not maintained at 6 and 12 months suggesting similar efficacy of both classes. CONCLUSIONS: Both anti-TNF and VDZ therapy were similarly effective and safe in elderly IBDpatients.
Authors: Ashwin N Ananthakrishnan; Hai Yun Shi; Whitney Tang; Cindy C Y Law; Joseph J Y Sung; Francis K L Chan; Siew C Ng Journal: J Crohns Colitis Date: 2016-02-29 Impact factor: 9.071
Authors: William J Sandborn; Brian G Feagan; Paul Rutgeerts; Stephen Hanauer; Jean-Frédéric Colombel; Bruce E Sands; Milan Lukas; Richard N Fedorak; Scott Lee; Brian Bressler; Irving Fox; Maria Rosario; Serap Sankoh; Jing Xu; Kristin Stephens; Catherine Milch; Asit Parikh Journal: N Engl J Med Date: 2013-08-22 Impact factor: 91.245
Authors: Jean-Frédéric Colombel; Bruce E Sands; Paul Rutgeerts; William Sandborn; Silvio Danese; Geert D'Haens; Remo Panaccione; Edward V Loftus; Serap Sankoh; Irving Fox; Asit Parikh; Catherine Milch; Brihad Abhyankar; Brian G Feagan Journal: Gut Date: 2016-02-18 Impact factor: 23.059
Authors: Romina di Giuseppe; Sandra Plachta-Danielzik; Wolfgang Mohl; Martin Hoffstadt; Thomas Krause; Bernd Bokemeyer; Stefan Schreiber Journal: Int J Colorectal Dis Date: 2021-05-08 Impact factor: 2.571