Persistence on Anti-Tumour Necrosis Factor Therapy in Older Patients with Inflammatory Bowel Disease Compared with Younger Patients: Data from the ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-02-04

AUTHORS

Serena Porcari, Anna Viola, Ambrogio Orlando, Antonino Carlo Privitera, Concetta Ferracane, Maria Cappello, Alessandro Vitello, Sebastiano Siringo, Gaetano Inserra, Antonio Magnano, Filippo Mocciaro, Roberto Di Mitri, Nunzio Belluardo, Oriana Fidanza, Serena Garufi, Giovanni Magrì, Carmelo Bertolami, Antonio Carroccio, Fabio Salvatore Macaluso, Sara Renna, Marco Ventimiglia, Angela Alibrandi, Mario Cottone, Walter Fries,

ABSTRACT

Background and ObjectiveOlder people with inflammatory bowel disease (IBD) appear to have a lower response to anti-tumour necrosis factor (TNF) therapy, with more frequent complications than younger patients. The objective of this study was to assess persistence on therapy and the safety of anti-TNF therapy in older patients (aged ≥ 60 years).MethodsWe retrospectively reviewed the database of the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD), extracting data regarding IBD patients aged ≥ 60 years and controls < 60 years of age at their first course of anti-TNF treatment. Data concerning persistence on therapy over the first year of treatment (primary objective) together with data on reasons for treatment withdrawal, concomitant diseases and treatments were collected.ResultsWe identified 114 anti-TNF-naϊve patients aged ≥ 60 years (median age 64 years, range 60–80 years; 47 males) compared with 330 younger controls aged < 60 years (median age 39 years, range 18–59 years; 57 males). Older patients with Crohn’s disease (n = 73) showed a significantly lower persistence with every kind of anti-TNF therapy (whether analysed together [p < 0.001] or separately for intravenous and subcutaneous [SC] therapy) than younger controls, whereas older patients with ulcerative colitis (n = 41) showed a lower persistence when combining all kinds of anti-TNF treatment (p = 0.004) and for SC therapy. Secondary failures, infections, and neoplasias, but not primary failure, occurred more frequently in older IBD patients than in younger controls.ConclusionDespite a comparable number of primary failures, older IBD patients treated for the first time with anti-TNF agents showed lower treatment persistence due to higher rates of secondary failure, adverse events, infections, and tumours than younger patients in the first year of follow-up. The reasons for this difference still remain unclear. More... »

PAGES

383-392

References to SciGraph publications

Journal

TITLE

Drugs & Aging

ISSUE

5

VOLUME

37

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40266-020-00744-3

DOI

http://dx.doi.org/10.1007/s40266-020-00744-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1124555425

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32016824


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