Phenotype and natural history of elderly onset inflammatory bowel disease: a multicentre, case-control study
Por:
Manosa, M, Calafat, M, de Francisco, R, Garcia, C, Casanova, MJ, Huelin, P, Calvo, M, Tosca, J, Fernandez-Salazar, L, Arajol, C, Zabana, Y, Bastida, G, Hinojosa, J, Marquez, L, Barreiro-De-Acosta, M, Calvet, X, Monfort, D, Gomez-Garcia, MR, Rodriguez, E, Huguet, JM, Rojas-Feria, M, Hervias, D, Atienza, R, Busquets, D, Zapata, E, Duenas, C, Charro, M, Martinez-Cerezo, FJ, Plaza, R, Vazquez, JM, Gisbert, JP, Canete, F, Cabre, E and Domenech, E
Publicada:
1 mar 2018
Resumen:
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.
Filiaciones:
:
Hosp Univ Germans Trias i Pujol, Gastroenterol, Badalona, Catalonia, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Badalona, Spain
Calafat, M:
Hosp Univ Germans Trias i Pujol, Gastroenterol, Badalona, Catalonia, Spain
Univ Autonoma Barcelona, Badalona, Spain
de Francisco, R:
Hosp Univ Cent Asturias, Gastroenterol Serv, Oviedo, Spain
Garcia, C:
Hosp Univ Reina Sofia, Gastroenterol, Madrid, Spain
Casanova, MJ:
Hosp Univ La Princesa, Gastroenterol, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Huelin, P:
Hosp Santa Creu i Sant Pau, Dept Gastroenterol, Barcelona, Spain
Calvo, M:
Hosp Univ Puerta Hierro Majadahonda, Gastroenterol, Barcelona, Spain
Tosca, J:
Hosp Clin Valencia, Unidad Digest, Valencia, Spain
Fernandez-Salazar, L:
Hosp Clin Univ, Gastroenterol Serv, Valencia, Spain
Arajol, C:
Univ Bellvitge Hosp, Gastroenterol & Hepatol, Barcelona, Spain
Zabana, Y:
Hosp Mutua Terrassa, Gastroenterol, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Bastida, G:
Hosp Univ La Fe, Gastroenterol, Valencia, Spain
Hinojosa, J:
Hosp Manises, Gastroenterol Unit, Valencia, Spain
Marquez, L:
Res Inst Hosp Mar IMIM, Barcelona, Spain
Pompeu Fabra Univ, Gastroenterol Serv, Barcelona, Spain
Barreiro-De-Acosta, M:
Univ Hosp, Gastroenterol, Santiago, Spain
Calvet, X:
Univ Autonoma Barcelona, Digest Dis Dept, Hosp Sabadell,Ctr Invest Biomed Red Enfermedades, Inst Univ ParcTauli,Dept Med,Inst Salud Carlos 3, Barcelona, Spain
Monfort, D:
Consorci Sanitari Terrassa, Barcelona, Spain
Gomez-Garcia, MR:
Hosp Univ Virgen de Las Nieves, Granada, Spain
Rodriguez, E:
Hosp Univ Nuestra Senora Candelaria, Canarias, Spain
Huguet, JM:
Hosp Gen Univ Valencia, Valencia, Spain
Rojas-Feria, M:
Univ Hosp Valme, Unit Clin Management Digest Dis, Seville, Spain
Gisbert, JP:
La Princesa Univ Hosp, Gastroenterol, Madrid, Spain
:
Hosp Univ Germans Trias i Pujol, Gastroenterol, Badalona, Catalonia, Spain
:
Hosp Univ Germans Trias i Pujol, Gastroenterol, Badalona, Catalonia, Spain
:
Hosp Univ Germans Trias i Pujol, Gastroenterol, Badalona, Catalonia, Spain
Bronze
|