Elderly patients with inflammatory bowel disease: Updated review of the therapeutic landscape  

作　　者：Jean-Frédéric LeBlanc Daniel Wiseman Peter L Lakatos Talat Bessissow 

机构地区：[1]Department of Adult Gastroenterology,McGill University Health Centre,Montreal,QC H3G 1A4,Canada [2]Department of Medicine,McGill University Health Centre,Montreal,QC H3G 1A4,Canada [3]1^st Department of Medicine,Semmelweis University,Budapest 1083,Hungary

出　　处：《World Journal of Gastroenterology》2019年第30期4158-4171,共14页世界胃肠病学杂志（英文版）

摘　　要：High-quality data remains scarce in terms of optimal management strategies in the elderly inflammatory bowel disease(IBD)population.Indeed,available trials have been mostly retrospective,of small sample size,likely owing to underrepresentation of such a population in the major randomized controlled trials.However,in the last five years,there has been a steady increase in the number of published trials,helping clarify the estimated benefits and toxicity of the existing IBD armamentarium.In the Everhov trial,prescription strategies were recorded over an average follow-up of 4.2 years.A minority of elderly IBD patients(1%-3%)were treated with biologics within the five years following diagnosis,whilst almost a quarter of these patients were receiving corticosteroid therapy at year five of follow-up,despite its multiple toxicities.The low use of biologic agents in real-life settings likely stems from limited data suggesting lower efficacy and higher toxicity.This minireview will aim to highlight current outcome measurements as it portends the elderly IBD patient,as well as summarize the available therapeutic strategies in view of a growing body of evidence.High-quality data remains scarce in terms of optimal management strategies in the elderly inflammatory bowel disease(IBD) population.Indeed, available trials have been mostly retrospective, of small sample size, likely owing to underrepresentation of such a population in the major randomized controlled trials.However, in the last five years, there has been a steady increase in the number of published trials, helping clarify the estimated benefits and toxicity of the existing IBD armamentarium.In the Everhov trial, prescription strategies were recorded over an average follow-up of 4.2 years.A minority of elderly IBD patients(1%-3%) were treated with biologics within the five years following diagnosis, whilst almost a quarter of these patients were receiving corticosteroid therapy at year five of follow-up, despite its multiple toxicities.The low use of biologic agents in real-life settings likely stems from limited data suggesting lower efficacy and higher toxicity.This minireview will aim to highlight current outcome measurements as it portends the elderly IBD patient, as well as summarize the available therapeutic strategies in view of a growing body of evidence.

关 键 词：INFLAMMATORY BOWEL disease ELDERLY OUTCOMES GLUCOCORTICOIDS Biological therapy Surgery 

分 类 号：R[医药卫生]