Elderly patients with inflammatory bowel disease: Updated review of the therapeutic landscape

Jean Frédéric LeBlanc, Daniel Wiseman, Peter L. Lakatos, Talat Bessissow

Research output: Contribution to journalReview article

Abstract

High-quality data remains scarce in terms of optimal management strategies in the elderly inflammatory bowel disease (IBD) population. Indeed, available trials have been mostly retrospective, of small sample size, likely owing to underrepresentation of such a population in the major randomized controlled trials. However, in the last five years, there has been a steady increase in the number of published trials, helping clarify the estimated benefits and toxicity of the existing IBD armamentarium. In the Everhov trial, prescription strategies were recorded over an average follow-up of 4.2 years. A minority of elderly IBD patients (1%- 3%) were treated with biologics within the five years following diagnosis, whilst almost a quarter of these patients were receiving corticosteroid therapy at year five of follow-up, despite its multiple toxicities. The low use of biologic agents in real-life settings likely stems from limited data suggesting lower efficacy and higher toxicity. This minireview will aim to highlight current outcome measurements as it portends the elderly IBD patient, as well as summarize the available therapeutic strategies in view of a growing body of evidence.

Original languageEnglish
Pages (from-to)4158-4171
Number of pages14
JournalWorld journal of gastroenterology
Volume25
Issue number30
DOIs
Publication statusPublished - Aug 14 2019

Keywords

  • Biological therapy
  • Elderly
  • Glucocorticoids
  • Inflammatory bowel disease
  • Outcomes
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

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