Mañosa M, et al. - In patients with elderly onset inflammatory bowel disease (IBD), the researchers evaluated phenotypic characteristics and the use of therapeutic resources. Findings revealed specific characteristics of elderly-onset IBD. These were managed differently, with a lower use of immunosuppressants and a higher rate of surgery in ulcerative colitis (UC).

Methods

• From the IBD databases, researchers identified all those patients diagnosed with IBD over the age of 60 years since 2000 who were followed-up for >12 months, for this case-control study.
• They performed comparison of elderly onset cases with IBD patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of IBD (adult-onset).

Results

• Researchers included 1,374 elderly onset and 1,374 adult-onset cases (62% ulcerative colitis (UC), 38% Crohn's disease (CD)).
• A lower proportion of extensive disease was shown by elderly onset UC patients (33% vs 39%; P < 0.0001).
• Elderly onset UC cases showed an increased rate of stenosing pattern (24% vs 13%; P < 0.0001) and exclusive colonic location (28% vs 16%; P < 0.0001); however they showed significantly less frequent penetrating pattern (12% vs 19%; P < 0.0001).
• In terms of the therapeutic resources use, a significantly lower use of corticosteroids (P < 0.0001), immunosuppressants (P < 0.0001) and anti-TNFs agents (P < 0.0001) was observed in elderly onset cases.
• In terms of surgery, a significantly higher surgery rate was observed among elderly onset UC cases (8.3% vs 5.1%; P < 0.009).
• Finally, a higher rate of hospitalisations (66% vs 49%; P < 0.0001) and neoplasms (14% vs 0.5%; P < 0.0001) were evident among elderly onset cases.