Disease patterns in late-onset ulcerative colitis: Results from the IG-IBD “AGED study”

Walter Fries, Anna Maria Viola, Natalia Manetti, Iris Frankovic, Daniela Pugliese, Rita Monterubbianesi, Giuseppe Scalisi, Annalisa Aratari, Laura Cantoro, Maria Cappello, Leonardo Samperi, Simone Saibeni, Giovanni Casella, Giammarco Mocci, Matilde Rea, Federica Furfaro, Antonella Contaldo, Andrea Magarotto, Francesca Calella, Francesco MangusoGaetano Inserra, Antonino C. Privitera, Mariabeatrice Principi, Fabiana Castiglione, Flavio Caprioli, Sandro Ardizzone, Silvio Danese, Claudio Papi, Fabrizio Bossa, Anna Kohn, Alessandro Armuzzi, Renata D'Incà, Vito Annese, Angela Alibrandi, Stefanos Bonovas, Gionata Fiorino

Research output: Contribution to journalArticlepeer-review

Abstract

Background Late-onset UC represents an important issue for the near future, but its outcomes and relative therapeutic strategies are yet poorly studied. Aim To better define the natural history of late-onset ulcerative colitis. Methods In a multicenter retrospective study, we investigated the disease presentation and course in the first 3 years in 1091 UC patients divided into 3 age-groups: diagnosis ≥65 years, 40–64 years, and <40 years. Disease patterns, medical and surgical therapies, and risk factors for disease outcomes were analyzed. Results Chronic active or relapsing disease accounts for 44% of patients with late-onset UC. Across all age-groups, these disease patterns require 3–6 times more steroids than remitting disease, but immunomodulators and, to a lesser extent, biologics are less frequently prescribed in the elderly. Advanced age, concomitant diseases and related therapies were found to be inversely associated with the use of immunomodulators or biologics, but not with surgery. Conclusions The conclusion that late-onset UC follows a mild course may apply only to a subset of patients. an important percentage of elderly patients present with more aggressive disease. Since steroid use and surgery rates did not differ in this subgroup, lower use of immunosuppressive therapy and biologics may reflect concerns in prescribing these therapies in the elderly.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalDigestive and Liver Disease
Volume49
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

Keywords

  • Outcome
  • Steroids
  • Surgery
  • Thiopurines
  • Tumors

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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