Real-World Effectiveness and Safety of Ustekinumab in Elderly Crohn's Disease Patients.
Dig Dis Sci
; 67(7): 3138-3147, 2022 07.
Article
en En
| MEDLINE
| ID: mdl-34160735
ABSTRACT
INTRODUCTION:
The efficacy and safety profile of ustekinumab (UST) in Crohn's disease (CD) is favorable; however, data in elderly patients are lacking. We aimed to assess the safety and efficacy of UST in elderly CD.METHODS:
We performed a retrospective cohort study of CD patients classified as elderly (age ≥ 65 years at UST initiation) or nonelderly (<65 years) treated at a large, tertiary referral center. Outcomes assessed were clinical (measured by physician global assessment [PGA]) and steroid-free response, remission, adverse events, and postsurgical complications were compared by age category. Multivariable regression modeling and survival analysis was also performed.RESULTS:
In total, 117 patients (elderly n = 39, nonelderly n = 78) were included in the study. Elderly patients had predominantly moderate disease (87.2%), while nonelderly had a higher proportion of severe disease activity (44.9%) (p = 0.001), though no differences in baseline endoscopic activity, prior biologic use, or steroid or immunomodulator use at baseline existed (p > 0.05 all). While nearly 90% patients in both groups experienced clinical response to UST, compared to nonelderly, elderly patients were less likely to achieve complete clinical remission (28.2% vs. 52.6%, p = 0.01). On regression modeling, age was not associated with clinical outcomes (p > 0.05 all). Mucosal healing was achieved in 26% elderly and 30% nonelderly patients (p = 0.74). There were no significant differences in infusion reactions (2.6% vs. 6.4%, p = 0.77), infection (5.2% vs. 7.7%, p = 0.7), or postsurgical complications (p = 0.99) by age category.CONCLUSION:
UST is safe and effective in elderly CD. Although limited by sample size and retrospective design, such real-world data can inform biologic positioning in this IBD population.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Productos Biológicos
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Enfermedad de Crohn
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Fármacos Dermatológicos
/
Ustekinumab
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Prognostic_studies
Límite:
Aged
/
Humans
Idioma:
En
Revista:
Dig Dis Sci
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos