Advanced Age Is an Independent Risk Factor for Severe Infections and Mortality in Patients Given Anti-Tumor Necrosis Factor Therapy for Inflammatory Bowel Disease

Mario Cottone, Anna Kohn, Marco Daperno, Alessandro Armuzzi, Luisa Guidi, Renata D'Inca, Fabrizio Bossa, Erika Angelucci, Livia Biancone, Paolo Gionchetti, Sandro Ardizzone, Claudio Papi, Walter Fries, Silvio Danese, Gabriele Riegler, Maria Cappello, Fabiana Castiglione, Vito Annese, Ambrogio Orlando

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)30-35
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number1
DOIs
Publication statusPublished - Jan 2011

Keywords

  • Aging
  • Drug Complications
  • Inflammation
  • Side Effects

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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