Elderly-onset Inflammatory Bowel Disease Research Articles

Oral corticosteroids and the risk of serious infections in patients with elderly-onset inflammatory bowel diseases.

Systemic corticosteroids are among the most common anti-inflammatory treatments in elderly-onset inflammatory bowel disease (IBD) patients. Steroid use and older age each independently predisposes to infections, and infections increase mortality in hospitalized older IBD patients. Therefore, our objective was to examine the risk of serious infections in elderly-onset IBD patients treated with oral corticosteroids, and explore how the timing of exposure affects the risk estimates. Using the health-care databases of the province of Quebec, Canada, we conducted a population-based cohort study with a nested case-control analysis. Incident IBD patients aged ≥66 years were identified. Conditional logistic regression was performed to estimate crude and adjusted rate ratios (aRRs) with 95% confidence intervals (CIs). We identified 3,522 elderly-onset patients, of which 564 cases with serious infections were identified during a mean 4.4 years of follow-up (incidence rate 3.7 per 100 per year) and matched to 2,646 controls. The rate of serious infections was significantly higher in those exposed to oral corticosteroids any time during the previous 6-month period compared with those nonexposed (aRR 2.3; 95% CI 1.8-2.9). Those currently exposed (within 45 days) had a higher risk (aRR 2.8; 95% CI 2.1-3.7). The residual effect of oral corticosteroids remained marginally statistically significant up to the 90-day period before the index date (aRR 1.7; 95% CI 1.0-2.7). We found an excess relative risk for serious infections in elderly-onset IBD patients on oral corticosteroid therapy. Those with current exposure demonstrated a higher vulnerability to infections.

558 Reactivity of Lower Esophageal Sphincter (LES) Upon Pharyngeal Provocation in Infants With Hypoxic Ischemic Encephalopathy (HIE)

The ageing of the population makes elderly-onset inflammatory bowel diseases (IBD) a rising problem. Risk of cancer is unknown in this population. We studied this risk in a populationbased cohort of patients with IBD. Patients and methods: In a French population-based cohort, we identified 841 IBD patients >60 years of age at diagnosis from 1988 to 2006, including 367 Crohn's disease (CD) and 472 ulcerative colitis (UC)1. We compared incidence of cancer among patients with IBD with that observed in the French Network of populationbased Cancer Registries (FRANCIM). Only cancers occurring after IBD diagnosis were taken into account. Confidence interval (CI) was estimated assuming a Poisson specific law for rare events. Results were expressed using the standardized ratios of incidence (SIR) and their CI 95%. Results: After a median follow-up of 6 years [2-11], 103 (12.3%) patients with IBD including 42 CD and 61 UC developed a cancer corresponding to a SIR of 1.00 [0.83-1.21]. Eleven patients (1.3%) developed at least 2 cancers.There was no increased risk of colorectal cancer in IBD (SIR=1.06 [0.65-1.72], CD (SIR=1.15 [0.54-2.40] and UC (SIR=0.99 [0.52-1.91] without significant protective role of 5-ASA (HR=0.7 [0.2-2.6]). An increased risk of malignant lymphoproliferative disorders was found in IBD (SIR=2.71 [1.415.20] and in UC (SIR=3.05 [1.37-6.79]) but not in CD (SIR=2.21 [0.71-6.86]). An increased risk of extraintestinal tumors was observed only for the liver in CD (SIR=3.25 [1.04-4.07]). Immunomodulator exposure (n=26) was not associated with an increased risk of cancer (SIR=0.75 [0.43-1.29]) nor with any specific risk including malignant lymphoproliferative disorders (SIR=1.89 [0.26-13.44]). Only 2 patients of this cohort received biotherapy. Conclusions: There is no increased risk for developing intestinal cancer among patients with elderly-onset IBD in this population-based cohort. There is an increased risk of developing malignant lymphoproliferative disorders in UC and an increased risk for developing liver cancer in CD. These data reinforce the peculiarity of elderly-onset IBD as compared with younger age at onset IBD1. 1 Charpentier C et al. Gut 2013

962 Risks of Hospitalizations and Surgery in Elderly-Onset Inflammatory Bowel Disease: A Population Based Study

962 Risks of Hospitalizations and Surgery in Elderly-Onset Inflammatory Bowel Disease: A Population Based Study

557 Cancer in Elderly-Onset Inflammatory Bowel Disease: A Population-Based Study

557 Cancer in Elderly-Onset Inflammatory Bowel Disease: A Population-Based Study

P606 Phenotypic characteristics and use of therapeutic resources in elderly-onset inflammatory bowel disease: A multicentre, case-control study

P606 Phenotypic characteristics and use of therapeutic resources in elderly-onset inflammatory bowel disease: A multicentre, case-control study

DOP094 Cancer in elderly-onset inflammatory bowel disease: A population-based study

DOP094 Cancer in elderly-onset inflammatory bowel disease: A population-based study

Natural history of inflammatory bowel disease in the elderly

In the West in the past 50 years, the incidence and prevalence of inflammatory bowel diseases (IBD) have increased from 8–14/105 and 120–200/105 persons, respectively, for ulcerative colitis (UC) and 6–15/105 and 50–200/105 persons, respectively, for Crohn's disease (CD). In addition, the ageing of the population makes elderly-onset IBD a rising problem. Most natural history data on elderly-onset IBD patients and their therapeutic management are from tertiary referral centres. A better understanding of the epidemiology and natural history of elderly-onset IBD patients is strongly needed as the first step in improving the quality of care delivered to elderly patients. This review focuses on the natural history, clinical course and therapeutic outcomes of elderly-onset IBD patients from EPIMAD—a large French population-based registry.

Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study

Data on the natural history of elderly-onset inflammatory bowel disease (IBD) are scarce.MethodsIn a French population-based cohort we identified 841 IBD patients >60 years of age at diagnosis from 1988...

P631 Natural history of elderly onset inflammatory bowel disease – Sydney IBD Cohort (1942–2012)

P631 Natural history of elderly onset inflammatory bowel disease – Sydney IBD Cohort (1942–2012)

Experiences with elderly onset IBD

Introduction and Aims: Inflammatory Bowel Diseases (IBD) are considered to have a bimodal presentation: one peak at the second or third and another peak at the fifth or sixth decade of life. Elderly onset IBD is considered to show different disease characteristics as compared to young age onset. Therefore, the aim of this study was to analyze disease characteristics in elderly onset IBD in comparison to literature data.