Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease.

Mario Cottone, Livia Biancone, Erika Angelucci, Gabriele Riegler, Anna Kohn, Marco Daperno, Claudio Papi, Alessandro Armuzzi, Renata D'Inca, Silvio Danese, Fabiana Castiglione, Sandro Ardizzone, Luisa Guidi, Paolo Gionchetti, Vito Annese, Walter Fries, Fabrizio Bossa

Risultato della ricerca: Article

190 Citazioni (Scopus)

Abstract

BACKGROUND & AIMS: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients.METHODS: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death.RESULTS: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died.CONCLUSIONS: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.
Lingua originaleEnglish
pagine (da-a)30-35
Numero di pagine6
RivistaClinical Gastroenterology and Hepatology
Volume9
Stato di pubblicazionePublished - 2011

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Inflammatory Bowel Diseases
Tumor Necrosis Factor-alpha
Mortality
Infection
Therapeutics
Neoplasms
Biological Therapy
Biological Products
Ulcerative Colitis
Crohn Disease
Hospitalization

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cita questo

Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease. / Cottone, Mario; Biancone, Livia; Angelucci, Erika; Riegler, Gabriele; Kohn, Anna; Daperno, Marco; Papi, Claudio; Armuzzi, Alessandro; D'Inca, Renata; Danese, Silvio; Castiglione, Fabiana; Ardizzone, Sandro; Guidi, Luisa; Gionchetti, Paolo; Annese, Vito; Fries, Walter; Bossa, Fabrizio.

In: Clinical Gastroenterology and Hepatology, Vol. 9, 2011, pag. 30-35.

Risultato della ricerca: Article

Cottone, M, Biancone, L, Angelucci, E, Riegler, G, Kohn, A, Daperno, M, Papi, C, Armuzzi, A, D'Inca, R, Danese, S, Castiglione, F, Ardizzone, S, Guidi, L, Gionchetti, P, Annese, V, Fries, W & Bossa, F 2011, 'Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease.', Clinical Gastroenterology and Hepatology, vol. 9, pagg. 30-35.
Cottone, Mario ; Biancone, Livia ; Angelucci, Erika ; Riegler, Gabriele ; Kohn, Anna ; Daperno, Marco ; Papi, Claudio ; Armuzzi, Alessandro ; D'Inca, Renata ; Danese, Silvio ; Castiglione, Fabiana ; Ardizzone, Sandro ; Guidi, Luisa ; Gionchetti, Paolo ; Annese, Vito ; Fries, Walter ; Bossa, Fabrizio. / Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease. In: Clinical Gastroenterology and Hepatology. 2011 ; Vol. 9. pagg. 30-35.
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title = "Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease.",
abstract = "BACKGROUND & AIMS: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients.METHODS: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3{\%}) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death.RESULTS: Among patients more than 65 years old who received infliximab and adalimumab, 11{\%} developed severe infections, 3{\%} developed neoplasms, and 10{\%} died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5{\%} developed severe infections, 2{\%} developed cancer, and 2{\%} died. Among control patients less than 65 years old, 2.6{\%} developed severe infections, none developed tumors, and 1{\%} died.CONCLUSIONS: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.",
keywords = "Biologics, Elderly, IBD, Safety",
author = "Mario Cottone and Livia Biancone and Erika Angelucci and Gabriele Riegler and Anna Kohn and Marco Daperno and Claudio Papi and Alessandro Armuzzi and Renata D'Inca and Silvio Danese and Fabiana Castiglione and Sandro Ardizzone and Luisa Guidi and Paolo Gionchetti and Vito Annese and Walter Fries and Fabrizio Bossa",
year = "2011",
language = "English",
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pages = "30--35",
journal = "Clinical Gastroenterology and Hepatology",
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TY - JOUR

T1 - Advanced age is anindependent risk factor for severe infections and mortality in patients givenanti-tumor necrosis factor therapy for inflammatory bowel disease.

AU - Cottone, Mario

AU - Biancone, Livia

AU - Angelucci, Erika

AU - Riegler, Gabriele

AU - Kohn, Anna

AU - Daperno, Marco

AU - Papi, Claudio

AU - Armuzzi, Alessandro

AU - D'Inca, Renata

AU - Danese, Silvio

AU - Castiglione, Fabiana

AU - Ardizzone, Sandro

AU - Guidi, Luisa

AU - Gionchetti, Paolo

AU - Annese, Vito

AU - Fries, Walter

AU - Bossa, Fabrizio

PY - 2011

Y1 - 2011

N2 - BACKGROUND & AIMS: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients.METHODS: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death.RESULTS: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died.CONCLUSIONS: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.

AB - BACKGROUND & AIMS: Few data are available on effects of biologic therapies in patients more than 65 years old with inflammatory bowel disease (IBD). We evaluated the risk and benefits of therapy with tumor necrosis factor (TNF) inhibitors in these patients.METHODS: We collected data from patients with IBD treated with infliximab (n = 2475) and adalimumab (n = 604) from 2000 to 2009 at 16 tertiary centers. Ninety-five patients (3%) were more than 65 years old (52 men; 37 with ulcerative colitis and 58 with Crohn's disease; 78 treated with infliximab and 17 with adalimumab). The control group comprised 190 patients 65 years old or younger who were treated with both biologics and 190 patients older than 65 years who were treated with other drugs. The primary end points were severe infection, cancer, or death.RESULTS: Among patients more than 65 years old who received infliximab and adalimumab, 11% developed severe infections, 3% developed neoplasms, and 10% died. No variable was associated with severe infection or death. Among control patients more than 65 years old, 0.5% developed severe infections, 2% developed cancer, and 2% died. Among control patients less than 65 years old, 2.6% developed severe infections, none developed tumors, and 1% died.CONCLUSIONS: Patients older than 65 years treated with TNF inhibitors for IBD have a high rate of severe infections and mortality compared with younger patients or patients of the same age that did not receive these therapeutics. The effects of anti-TNF agents in older patients with IBD should be more thoroughly investigated, because these patients have higher mortality related to hospitalization than younger patients.

KW - Biologics

KW - Elderly

KW - IBD

KW - Safety

UR - http://hdl.handle.net/10447/53748

M3 - Article

VL - 9

SP - 30

EP - 35

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

ER -