Risk of Immunomediated Adverse Events and Loss of Response to Infliximab in Elderly Patients with Inflammatory Bowel Disease: A Cohort Study of the ENEIDA Registry.
Elderly
adverse events
inflammatory bowel disease
Journal
Journal of Crohn's & colitis
ISSN: 1876-4479
Titre abrégé: J Crohns Colitis
Pays: England
ID NLM: 101318676
Informations de publication
Date de publication:
14 Jul 2022
14 Jul 2022
Historique:
received:
17
08
2021
revised:
19
10
2021
accepted:
01
12
2021
pubmed:
6
12
2021
medline:
19
7
2022
entrez:
5
12
2021
Statut:
ppublish
Résumé
Immunomediated adverse events [IAEs] are the most frequently reported infliximab [IFX]-related adverse events. Combination therapy may reduce their incidence, although this strategy is not recommended in elderly patients. We aimed to compare the rates of IFX-related IAEs and loss of response [LOR] in elderly and younger patients. Adult patients in the ENEIDA registry who had received a first course of IFX therapy were identified and grouped into two cohorts regarding age at the beginning of treatment [over 60 years and between 18 and 50 years]. The rates of IAEs and LOR were compared. In total, 939 patients [12%] who started IFX over 60 years of age and 6844 [88%] below 50 years of age were included. Elderly patients presented a higher proportion of AEs related to IFX [23.2% vs 19%; p = 0.002], infections [7.1% vs 4.3%; p < 0.001] and neoplasms [2.2% vs 0.5%; p < 0.001]. In contrast, the rates of IAEs [14.8% vs 14.8%; p = 0.999], infusion reactions [8.1% vs 8.1%; p = 0.989], late hypersensitivity [1.3% vs 1.2%; p = 0.895], paradoxical psoriasis [1% vs 1.5%; p = 0.187] and drug-induced lupus erythematosus [0.6% vs 0.7%; p = 0.947] were similar in elderly and younger patients. LOR rates were also similar between the two groups [20.5% vs 19.3%; p = 0.438]. In the logistic regression analysis, IFX monotherapy, extraintestinal manifestations and female gender were the only risk factors for IAEs, whereas IFX monotherapy, extraintestinal manifestations and Crohn's disease were risk factors for LOR. Elderly patients with inflammatory bowel disease have a similar risk of developing IFX-related IAEs and LOR to that of younger patients.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Immunomediated adverse events [IAEs] are the most frequently reported infliximab [IFX]-related adverse events. Combination therapy may reduce their incidence, although this strategy is not recommended in elderly patients. We aimed to compare the rates of IFX-related IAEs and loss of response [LOR] in elderly and younger patients.
METHODS
METHODS
Adult patients in the ENEIDA registry who had received a first course of IFX therapy were identified and grouped into two cohorts regarding age at the beginning of treatment [over 60 years and between 18 and 50 years]. The rates of IAEs and LOR were compared.
RESULTS
RESULTS
In total, 939 patients [12%] who started IFX over 60 years of age and 6844 [88%] below 50 years of age were included. Elderly patients presented a higher proportion of AEs related to IFX [23.2% vs 19%; p = 0.002], infections [7.1% vs 4.3%; p < 0.001] and neoplasms [2.2% vs 0.5%; p < 0.001]. In contrast, the rates of IAEs [14.8% vs 14.8%; p = 0.999], infusion reactions [8.1% vs 8.1%; p = 0.989], late hypersensitivity [1.3% vs 1.2%; p = 0.895], paradoxical psoriasis [1% vs 1.5%; p = 0.187] and drug-induced lupus erythematosus [0.6% vs 0.7%; p = 0.947] were similar in elderly and younger patients. LOR rates were also similar between the two groups [20.5% vs 19.3%; p = 0.438]. In the logistic regression analysis, IFX monotherapy, extraintestinal manifestations and female gender were the only risk factors for IAEs, whereas IFX monotherapy, extraintestinal manifestations and Crohn's disease were risk factors for LOR.
CONCLUSIONS
CONCLUSIONS
Elderly patients with inflammatory bowel disease have a similar risk of developing IFX-related IAEs and LOR to that of younger patients.
Identifiants
pubmed: 34864947
pii: 6448705
doi: 10.1093/ecco-jcc/jjab213
doi:
Substances chimiques
Gastrointestinal Agents
0
Infliximab
B72HH48FLU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
946-953Subventions
Organisme : AbbVie
Organisme : Galápagos
Organisme : Janssen
Organisme : Biogen
Organisme : Takeda Foundation
Organisme : Pfizer
Investigateurs
Margalida Calafat
(M)
Míriam Mañosa
(M)
Elena Ricart
(E)
Pilar Nos
(P)
Eva Iglesias
(E)
Isabel Vera
(I)
Antonio López-Sanromán
(A)
Jordi Guardiola
(J)
Carlos Taxonera
(C)
Miguel Mínguez
(M)
M Dolores Martín-Arranz
(MD)
Luisa de Castro
(L)
Ruth de Francisco
(R)
Montserrat Rivero
(M)
Esther Garcia-Planella
(E)
Xavier Calvet
(X)
Santiago García-López
(S)
Lucía Márquez
(L)
Fernando Gomollón
(F)
Jesús Barrio
(J)
Maria Esteve
(M)
Fernando Muñoz
(F)
Javier P Gisbert
(JP)
Ana Gutiérrez
(A)
Joaquín Hinojosa
(J)
Federico Argüelles-Arias
(F)
David Busquets
(D)
Luís Bujanda
(L)
JoséL Pérez-Calle
(J)
Beatriz Sicilia
(B)
Olga Merino
(O)
Pilar Martínez
(P)
Fernando Bermejo
(F)
Rufo Lorente
(R)
Manuel Barreiro-de Acosta
(M)
Cristina Rodríguez
(C)
Mariana Fe García-Sepulcre
(M)
David Monfort
(D)
Patricia Romero
(P)
Carlos Tardillo
(C)
Óscar Roncero
(Ó)
Jordina Llaó
(J)
Guillermo Alcaín
(G)
Núria Rull
(N)
Mónica Sierra-Ausín
(M)
Luís Fernández-Salazar
(L)
Jair Morales-Alvarado
(J)
Mercè Navarro-Llavat
(M)
Miguel A Montoro
(MA)
Carmen Muñoz-Villafranca
(C)
Alfredo J Lucendo
(AJ)
Manuel Van Domselaar
(M)
Ainhoa Rodríguez-Pescador
(A)
Laura Ramos
(L)
Sandra Estrecha
(S)
Pedro Almela
(P)
Ramón Pajares
(R)
Sam Khorrami
(S)
Rosa Eva Madrigal
(R)
Eva Sesé
(E)
Ana Mª Trapero
(AM)
Jesús Legido
(J)
Pau Gilabert
(P)
Fiorella Cañete
(F)
Eugeni Domènech
(E)
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.