Abstract
Background & Aims: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients. Methods: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death. Results: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died. Conclusions: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.
| Original language | English |
|---|---|
| Pages (from-to) | 30-35 |
| Number of pages | 6 |
| Journal | Clinical Gastroenterology and Hepatology |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2011 |
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Keywords
- Aging
- Drug Complications
- Inflammation
- Side Effects
ASJC Scopus subject areas
- Gastroenterology
- Hepatology
Cite this
Advanced Age Is an Independent Risk Factor for Severe Infections and Mortality in Patients Given Anti-Tumor Necrosis Factor Therapy for Inflammatory Bowel Disease. / Cottone, Mario; Kohn, Anna; Daperno, Marco; Armuzzi, Alessandro; Guidi, Luisa; D'Inca, Renata; Bossa, Fabrizio; Angelucci, Erika; Biancone, Livia; Gionchetti, Paolo; Ardizzone, Sandro; Papi, Claudio; Fries, Walter; Danese, Silvio; Riegler, Gabriele; Cappello, Maria; Castiglione, Fabiana; Annese, Vito; Orlando, Ambrogio.
In: Clinical Gastroenterology and Hepatology, Vol. 9, No. 1, 01.2011, p. 30-35.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Advanced Age Is an Independent Risk Factor for Severe Infections and Mortality in Patients Given Anti-Tumor Necrosis Factor Therapy for Inflammatory Bowel Disease
AU - Cottone, Mario
AU - Kohn, Anna
AU - Daperno, Marco
AU - Armuzzi, Alessandro
AU - Guidi, Luisa
AU - D'Inca, Renata
AU - Bossa, Fabrizio
AU - Angelucci, Erika
AU - Biancone, Livia
AU - Gionchetti, Paolo
AU - Ardizzone, Sandro
AU - Papi, Claudio
AU - Fries, Walter
AU - Danese, Silvio
AU - Riegler, Gabriele
AU - Cappello, Maria
AU - Castiglione, Fabiana
AU - Annese, Vito
AU - Orlando, Ambrogio
PY - 2011/1
Y1 - 2011/1
N2 - Background & Aims: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients. Methods: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death. Results: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died. Conclusions: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.
AB - Background & Aims: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients. Methods: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death. Results: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died. Conclusions: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.
KW - Aging
KW - Drug Complications
KW - Inflammation
KW - Side Effects
UR - http://www.scopus.com/inward/record.url?scp=78649661962&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78649661962&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2010.09.026
DO - 10.1016/j.cgh.2010.09.026
M3 - Article
C2 - 20951835
AN - SCOPUS:78649661962
VL - 9
SP - 30
EP - 35
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
IS - 1
ER -