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老年炎症性肠病:聚焦疾病特征与生物治疗模式

Inflammatory Bowel Diseases in the Elderly: A Focus on Disease Characteristics and Biological Therapy Patterns.

作者信息

Talar-Wojnarowska Renata, Caban Miłosz, Jastrzębska Marta, Woźniak Małgorzata, Strigáč Aleksandra, Małecka-Wojciesko Ewa

机构信息

Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, 90-153 Lodz, Poland.

Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, 92-215 Lodz, Poland.

出版信息

J Clin Med. 2024 May 8;13(10):2767. doi: 10.3390/jcm13102767.

Abstract

: The incidence of inflammatory bowel diseases (IBDs) in elderly patients is constantly increasing. It results from the combination of an aging population with compounding prevalence of IBD, as well as the growing burden of elderly-onset IBD. The clinical characteristics of elderly patients differ from young subjects with IBD due to the multimorbidity or polypharmacy, affecting the choice of adequate therapeutic options. The aim of this study was to determine the clinical aspects and biological therapy safety in elderly Polish IBD patients. : We conducted a retrospective study aimed at describing the demographic, clinical, and management characteristics of IBD patients treated with a biological therapy in two referral centers within the National Drug Program in Poland. : Out of the entire group of 366 studied patients, 51 (13.9%) were aged over 60-32 with ulcerative colitis (UC) and 19 with Crohn's disease (CD). The disease location was predominantly ileocolonic (57.89%) in patients with CD and pancolitis for patients with UC (56.25%). Most of the elderly IBD subjects were characterized by significant comorbidities, with Charlson Comorbidity Index (CCI) ≥ 1 in 66.67% patients. The probability of stopping biological therapy due to adverse events had the tendency to be higher in the CCI ≥ 1 group (20.58% vs. 5.88% in CCI = 0; = 0.087). The main reasons for the therapy discontinuation included hypersensitivity reactions and liver enzyme abnormalities. : In conclusion, our results underline the importance of assessing the comorbidity status instead of the age prior to initiating biological therapy, analyzing additional safety risks, and close monitoring in IBD patients with multiple comorbidities.

摘要

炎症性肠病(IBD)在老年患者中的发病率持续上升。这是由于人口老龄化与IBD患病率的叠加,以及老年发病IBD负担的增加所致。由于多种疾病并存或联合用药,老年患者的临床特征与年轻IBD患者不同,这影响了适当治疗方案的选择。本研究的目的是确定波兰老年IBD患者的临床情况和生物治疗安全性。:我们进行了一项回顾性研究,旨在描述在波兰国家药物计划的两个转诊中心接受生物治疗的IBD患者的人口统计学、临床和管理特征。:在366名研究患者的整个队列中,51名(13.9%)年龄超过60岁,其中32名患有溃疡性结肠炎(UC),19名患有克罗恩病(CD)。CD患者的病变部位主要为回结肠(57.89%),UC患者为全结肠炎(56.25%)。大多数老年IBD患者具有明显的合并症,66.67%的患者Charlson合并症指数(CCI)≥1。CCI≥1组因不良事件停止生物治疗的可能性有更高的趋势(CCI = 0组为5.88%,CCI≥1组为20.58%;P = 0.087)。治疗中断的主要原因包括过敏反应和肝酶异常。:总之,我们的结果强调了在开始生物治疗前评估合并症状态而非年龄、分析额外安全风险以及对患有多种合并症的IBD患者进行密切监测的重要性。

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