P287 Clinical aspects of late-age Onset Inflammatory Bowel Disease

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a clinical condition affecting mainly young and middle-aged adults. However, a significant proportion of new IBD cases is diagnosed in older individuals, as the incidence of IBD and our population mean age are increasing. Older patients with IBD comprise two groups: those with a new diagnosis of IBD (Late-age onset IBD) and patients with juvenile or adult-onset IBD who have reached an advanced age. Patients with late-age onset IBD represent a significant challenge due to the inherent characteristics of this population, such as polypharmacy, comorbidities, and fragility, as well as the scarcity of specific IBD studies in this age range. We aimed to evaluate clinical aspects and epidemiology of late-age onset IBD patients (>60 years) as compared to patients with IBD diagnosed at earlier ages (<60 years). Methods Retrospective analysis of data from 63 patients with late-age onset IBD and 128 younger patients followed in an IBD referral center. Groups of patients including both Crohn’s disease (CD) and ulcerative colitis (UC) were randomized in a 1:2 ratio based on sex, disease location and phenotype, and year of diagnosis, from January 2001 to December 2021. Medical records data comprised disease severity, medical treatments, clinical and endoscopy remission, surgical treatment, comorbidities, and deaths. Results A total of 63 old-age onset IBD (57.1% female, 90.5% Caucasians, mean age: 72.00 ± 6.44 years; 52.4% UC) were included. Significantly lower utilization of immunomodulator [CD (36.7% vs. 70.0%; p=0.0020) UC (15.2% vs. 45.6%; p =0.003] and biological agents [CD (50.0% vs. 75.0%; p=0.020) UC (12.1% vs. 33.8%; p =0.003] was observed in old-age onset IBD patients. Higher disease severity was observed in patients with CD diagnosed at younger ages (90.0% vs. 66.7%; p=0.006). Higher frequency of comorbidities (92.06% vs. 31.25%; p<0.0001) and deaths (7.9 % vs. 0.7%; p=0.0015) were observed in old-age onset IBD patients. No significant differences were observed concerning clinical and endoscopy remission, use of corticosteroids and aminosalicylates and surgery (p>0.05). Conclusion Despite lower IBD severity and lower utilization of immunomodulators and biologic agents, late-onset patients have substantial comorbidities and higher mortality. Further studies in this specific population are needed.