Ulcerative Colitis in Adulthood and in Older Patients: Same Disease, Same Outcome, Same Risks?
Journal
Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
accepted:
09
05
2022
pubmed:
1
6
2022
medline:
29
6
2022
entrez:
31
5
2022
Statut:
ppublish
Résumé
The number of patients with inflammatory bowel disease (IBD) approaching an older age, together with the number of over-60-year-old patients newly diagnosed with IBD, is steadily increasing, reaching 25% of all patients. The present review focuses on late-onset ulcerative colitis (UC) and its initial disease course in comparison with that observed in younger adults in terms of extension at onset and the risk of proximal disease progression, medical treatment, surgery and hospitalization in the first years after diagnosis. We summarize the clues pointing to a milder disease course in a population which frequently presents major frailty due to comorbidities. With increasing age and thus increasing comorbidities, medical and surgical therapies frequently represent a challenge for treating physicians. The response, persistence, and risks of adverse events of conventional therapies indicated for late onset/older UC patients are examined, emphasizing the risks in this particular population, who are still being treated with prolonged corticosteroid therapy. Finally, we concentrate on data on biotechnological agents for which older patients were mostly excluded from pivotal trials. Real-life data from newer agents such as vedolizumab and ustekinumab show encouraging efficacy and safety profiles in the population of older UC patients.
Identifiants
pubmed: 35641753
doi: 10.1007/s40266-022-00943-0
pii: 10.1007/s40266-022-00943-0
pmc: PMC9155981
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-452Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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