Comparison of Disease Phenotype and Course among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East.

Vosoghinia, Hasan; Saberzadeh-Ardestani, Bahar; Anushiravani, Amir; Mansour-Ghanaei, Fariborz; Fakheri, Hafez; Vahedi, Homayoon; Sheikhesmaeili, Farshad; Yazdanbod, Abbas; Moosavy, Seyed Hamid; Maleki, Iradj; Nasseri-Moghaddam, Siavosh; Khosravi, Bardia; Malekzadeh, Masoud; Kasaeian, Amir; Alatab, Sudabeh; Sadeghi, Anahita; Kolahdoozan, Shadi; Amani, Mohammad; Saberhosseini, Seyedeh Naeimeh; Rayatpisheh, Maryam

Background: It is unknown if the clinical manifestations and phenotype of disease are comparable between early- and elderlyonset inflammatory bowel disease (IBD). We aimed to seek differences in disease phenotype, course, complications, and treatment between early- and elderly-onset IBD patients. Methods: This retrospective cohort study on registered IBD patients in the Iranian Registry of Crohn's and Colitis (IRCC) compared demographics, disease phenotype, disease activity, IBD-related surgery and medications between early- and elderly-onset IBD. A generalized linear regression model was used to investigate the relative risk of age at diagnosis adjusted for gender and disease duration for the outcomes. Results: From 10 048 IBD patients, 749 with early-onset (7.5%), and 472 (4.7%) elderly-onset IBD were enrolled: 855 (63.1%) ulcerative colitis (UC) and 366 (26.9%) Crohn's disease (CD). Left-sided colitis was more frequent among elderly-onset UC patients (P < 0.001). Ileum and ileocolonic locations were the most common types in elderly-onset and early-onset CD patients, respectively. In comparison with elderly-onset UC, early-onset cases more often used prednisolone (22.1% vs. 11.4%, P = 0.001), immunomodulators (44.9% vs 25.2%, P < 0.001) and anti-tumor necrosis factors (TNF) (20.1% vs 11.9%, P = 0.002). Elderly-onset UC patients had 0.7 times lower risk of aggressive phenotype (95%CI:0.6-0.9, P = 0.005). Early-onset CD was associated with higher use of prednisolone (27.7% vs 8.1%, P < 0.001), immunomodulators (58.7% vs 41.8%, P = 0.005) and anti-TNF (49.6% vs 35.4%, P = 0.006). Conclusion: Early-onset IBD was associated with a more aggressive phenotype and higher prednisolone, immunomodulators, and anti-TNF use.

MIDDLE East; INFLAMMATORY bowel disease treatment; DISEASE progression; CROHN'S disease; ULCERATIVE colitis; RELATIVE medical risk; INFLAMMATORY bowel diseases; PREDNISOLONE; CONFIDENCE intervals; RETROSPECTIVE studies; ACQUISITION of data; REGRESSION analysis; IMMUNOMODULATORS; COMPARATIVE studies; AGE factors in disease; MEDICAL records; SYMPTOMS; DISEASE duration; DESCRIPTIVE statistics; TUMOR necrosis factors; RESEARCH funding; DEMOGRAPHY; PHENOTYPES; LONGITUDINAL method; DISEASE complications; OLD age

Archives of Iranian Medicine (AIM), 2023, Vol 26, Issue 9, p481

1029-2977

Academic Journal

10.34172/aim.2023.73