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, Italian Group for the study of Inflammatory Bowel Disease (IG-IBD)

Research output: Contribution to journalArticle

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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 ≥65years, 40-64 years, and <40years. 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 2017

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Ulcerative Colitis
Immunologic Factors
Biological Products
Age Groups
Steroids
Biological Therapy
Therapeutics
Immunosuppressive Agents
Natural History
Multicenter Studies
Retrospective Studies

Keywords

  • Journal Article

Cite this

Fries, W., Viola, A. M., Manetti, N., Frankovic, I., Pugliese, D., Monterubbianesi, R., ... Italian Group for the study of Inflammatory Bowel Disease (IG-IBD) (2017). Disease patterns in late-onset ulcerative colitis: Results from the IG-IBD "AGED study". Digestive and Liver Disease, 49(1), 17-23. https://doi.org/10.1016/j.dld.2016.09.006

Disease patterns in late-onset ulcerative colitis : Results from the IG-IBD "AGED study". / Fries, Walter; Viola, Anna Maria; Manetti, Natalia; Frankovic, Iris; Pugliese, Daniela; Monterubbianesi, Rita; Scalisi, Giuseppe; Aratari, Annalisa; Cantoro, Laura; Cappello, Maria; Samperi, Leonardo; Saibeni, Simone; Casella, Giovanni; Mocci, Giammarco; Rea, Matilde; Furfaro, Federica; Contaldo, Antonella; Magarotto, Andrea; Calella, Francesca; Manguso, Francesco; Inserra, Gaetano; Privitera, Antonino C.; Principi, Mariabeatrice; Castiglione, Fabiana; Caprioli, Flavio; Ardizzone, Sandro; Danese, Silvio; Papi, Claudio; Bossa, Fabrizio; Kohn, Anna; Armuzzi, Alessandro; D'Incà, Renata; Annese, Vito; Alibrandi, Angela; Bonovas, Stefanos; Fiorino, Gionata; Italian Group for the study of Inflammatory Bowel Disease (IG-IBD).

In: Digestive and Liver Disease, Vol. 49, No. 1, 01.2017, p. 17-23.

Research output: Contribution to journalArticle

Fries, W, Viola, AM, Manetti, N, Frankovic, I, Pugliese, D, Monterubbianesi, R, Scalisi, G, Aratari, A, Cantoro, L, Cappello, M, Samperi, L, Saibeni, S, Casella, G, Mocci, G, Rea, M, Furfaro, F, Contaldo, A, Magarotto, A, Calella, F, Manguso, F, Inserra, G, Privitera, AC, Principi, M, Castiglione, F, Caprioli, F, Ardizzone, S, Danese, S, Papi, C, Bossa, F, Kohn, A, Armuzzi, A, D'Incà, R, Annese, V, Alibrandi, A, Bonovas, S, Fiorino, G & Italian Group for the study of Inflammatory Bowel Disease (IG-IBD) 2017, 'Disease patterns in late-onset ulcerative colitis: Results from the IG-IBD "AGED study"', Digestive and Liver Disease, vol. 49, no. 1, pp. 17-23. https://doi.org/10.1016/j.dld.2016.09.006
Fries W, Viola AM, Manetti N, Frankovic I, Pugliese D, Monterubbianesi R et al. Disease patterns in late-onset ulcerative colitis: Results from the IG-IBD "AGED study". Digestive and Liver Disease. 2017 Jan;49(1):17-23. https://doi.org/10.1016/j.dld.2016.09.006
Fries, Walter ; Viola, Anna Maria ; Manetti, Natalia ; Frankovic, Iris ; Pugliese, Daniela ; Monterubbianesi, Rita ; Scalisi, Giuseppe ; Aratari, Annalisa ; Cantoro, Laura ; Cappello, Maria ; Samperi, Leonardo ; Saibeni, Simone ; Casella, Giovanni ; Mocci, Giammarco ; Rea, Matilde ; Furfaro, Federica ; Contaldo, Antonella ; Magarotto, Andrea ; Calella, Francesca ; Manguso, Francesco ; Inserra, Gaetano ; Privitera, Antonino C. ; Principi, Mariabeatrice ; Castiglione, Fabiana ; Caprioli, Flavio ; Ardizzone, Sandro ; Danese, Silvio ; Papi, Claudio ; Bossa, Fabrizio ; Kohn, Anna ; Armuzzi, Alessandro ; D'Incà, Renata ; Annese, Vito ; Alibrandi, Angela ; Bonovas, Stefanos ; Fiorino, Gionata ; Italian Group for the study of Inflammatory Bowel Disease (IG-IBD). / Disease patterns in late-onset ulcerative colitis : Results from the IG-IBD "AGED study". In: Digestive and Liver Disease. 2017 ; Vol. 49, No. 1. pp. 17-23.
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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 ≥65years, 40-64 years, and <40years. 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.",
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T1 - Disease patterns in late-onset ulcerative colitis

T2 - Results from the IG-IBD "AGED study"

AU - Fries, Walter

AU - Viola, Anna Maria

AU - Manetti, Natalia

AU - Frankovic, Iris

AU - Pugliese, Daniela

AU - Monterubbianesi, Rita

AU - Scalisi, Giuseppe

AU - Aratari, Annalisa

AU - Cantoro, Laura

AU - Cappello, Maria

AU - Samperi, Leonardo

AU - Saibeni, Simone

AU - Casella, Giovanni

AU - Mocci, Giammarco

AU - Rea, Matilde

AU - Furfaro, Federica

AU - Contaldo, Antonella

AU - Magarotto, Andrea

AU - Calella, Francesca

AU - Manguso, Francesco

AU - Inserra, Gaetano

AU - Privitera, Antonino C.

AU - Principi, Mariabeatrice

AU - Castiglione, Fabiana

AU - Caprioli, Flavio

AU - Ardizzone, Sandro

AU - Danese, Silvio

AU - Papi, Claudio

AU - Bossa, Fabrizio

AU - Kohn, Anna

AU - Armuzzi, Alessandro

AU - D'Incà, Renata

AU - Annese, Vito

AU - Alibrandi, Angela

AU - Bonovas, Stefanos

AU - Fiorino, Gionata

AU - Italian Group for the study of Inflammatory Bowel Disease (IG-IBD)

N1 - Copyright © 2016. Published by Elsevier Ltd.

PY - 2017/1

Y1 - 2017/1

N2 - 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 ≥65years, 40-64 years, and <40years. 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.

AB - 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 ≥65years, 40-64 years, and <40years. 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.

KW - Journal Article

U2 - 10.1016/j.dld.2016.09.006

DO - 10.1016/j.dld.2016.09.006

M3 - Article

C2 - 27717794

VL - 49

SP - 17

EP - 23

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 1

ER -