AI Article Synopsis
- Biologic therapy has significantly improved the management of inflammatory bowel disease (IBD) in general, but there is limited information on its effects and side effects specifically for elderly patients.
- A study analyzed 147 elderly IBD patients treated with various biologics over a 20-year period, measuring treatment effectiveness and safety through clinical scores and tracking adverse events.
- The results showed no significant differences in remission rates, drug sustainability, or adverse event rates among different biologics, indicating that all studied biologics have similar safety and effectiveness profiles for the elderly IBD population.
Article Abstract
Background: Biologic therapy resulted in a significant positive impact on the management of inflammatory bowel disease (IBD) however data on the efficacy and side effects of these therapies in the elderly is scant.
Aim: To evaluate retrospectively the drug sustainability, effectiveness, and safety of the biologic therapies in the elderly IBD population.
Methods: Consecutive elderly (≥ 60 years old) IBD patients, treated with biologics [infliximab (IFX), adalimumab (ADAL), vedolizumab (VDZ), ustekinumab (UST)] followed at the McGill University Inflammatory Bowel Diseases Center were included between January 2000 and 2020. Efficacy was measured by clinical scores at 3, 6-9 and 12-18 mo after initiation of the biologic therapy. Patients completing induction therapy were included. Adverse events (AEs) or serious AE were collected during and within three months of stopping of the biologic therapy.
Results: We identified a total of 147 elderly patients with IBD treated with biologicals during the study period, including 109 with Crohn's disease and 38 with ulcerative colitis. Patients received the following biologicals: IFX (28.5%), ADAL (38.7%), VDZ (15.6%), UST (17%). The mean duration of biologic treatment was 157.5 (SD = 148) wk. Parallel steroid therapy was given in 34% at baseline, 19% at 3 mo, 16.3% at 6-9 mo and 6.5% at 12-18 mo. The remission rates at 3, 6-9 and 12-18 mo were not significantly different among biological therapies. Kaplan-Meyer analysis did not show statistical difference for drug sustainability ( = 0.195), time to adverse event ( = 0.158) or infection rates ( = 0.973) between the four biologics studied. The most common AEs that led to drug discontinuation were loss of response, infusion/injection reaction and infection.
Conclusion: Current biologics were not different regarding drug sustainability, effectiveness, and safety in the elderly IBD population. Therefore, we are not able to suggest a preferred sequencing order among biologicals.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476849 | PMC |
| http://dx.doi.org/10.3748/wjg.v28.i33.4823 | DOI Listing |
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