Clinical characteristics of elderly-onset inflammatory bowel disease and its treatment options / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical characteristics of elderly-onset inflammatory bowel disease (IBD) and its treatment options.Methods Clinical data of IBD in-patients treated in Peking University First Hospital from January 1995 to December 2014 were reviewed and the subsequent information in the follow-up was also collected.Based on the onset age, patients were divided into the elderly-onset group (≥60 years old) and the control group (＜60 years old).The general situation, clinical characteristics and treatment options were retrospectively analyzed and compared between the two groups.Results There were 37 patients (9.3％) with IBD in the elderly-onset group, with 25 cases with ulcerative colitis (UC) and 12 cases with Crohn disease (CD).The ratio of gender, smoking, family history of IBD and colon cancer in the elderly-onset and control groups were 1 0.9 and 1 1.3, 32.4％ and 21.7％, 0.0％ and 6.1％, 0.0％ and 1.9％, respectively, with no significant differences between the two group (P=0.597, 0.139, 0.247 and 0.840).The attack frequency and the percentages of patients with persistent symptoms and severe disease had no statistical differences between the elderly onset and the control groups.Compared with the control group, the elderly-onset group showed that the percentage of UC patients with extensive colitis (E3) was decreased [16.0％ (4/25) vs.41.2％ (117/289) respectively (x2 =6.123, P=0.013)], and the percentage of CD patients with colonic type (L2) was increased [58.3％ (7/12)vs.21.3％ (16/75) respectively (x2=6.447, P=0.011)].For treatment options, the number of patients receiving 5-Aminosalicylic Acid (5-ASA)/sulfasalazine(SASP) as maintenance treatment for more than 1 years were 274 cases (96.9％) in the control group and 22 cases (86.5％) in the elderlyonset group (x2 =6.382, P=0.011).And the number of patients receiving systemic corticosteroids during induction period were 5 cases (19.4％) in the elderly-onset group and 122 case (43.2％) in the control group (x2 =7.617, P=0.006).There were no statistically significances in the number of patients with immunosuppressant, biologics and operation treatment between the two groups.Conclusions The elderly-onset IBD patients are not rare.The inflammation involvement is more limited in the elderly-onset patients than in the young-onset patients.The treatment option for elderlyonset IBD should be more cautious, especially for the treatment with 5-ASA/SASP long-term maintenance and systemic corticosteroids usage.