Scientific Reports (Mar 2022)

Elderly onset age is associated with low efficacy of first anti-tumor necrosis factor treatment in patients with inflammatory bowel disease

  • Takahiro Amano,
  • Shinichiro Shinzaki,
  • Akiko Asakura,
  • Taku Tashiro,
  • Mizuki Tani,
  • Yuriko Otake,
  • Takeo Yoshihara,
  • Shuko Iwatani,
  • Takuya Yamada,
  • Yuko Sakakibara,
  • Naoto Osugi,
  • Shuji Ishii,
  • Satoshi Egawa,
  • Manabu Araki,
  • Yuki Arimoto,
  • Masanori Nakahara,
  • Yoko Murayama,
  • Ichizo Kobayashi,
  • Kazuo Kinoshita,
  • Hiroyuki Ogawa,
  • Satoshi Hiyama,
  • Narihiro Shibukawa,
  • Masato Komori,
  • Yorihide Okuda,
  • Takashi Kizu,
  • Shunsuke Yoshii,
  • Yoshiki Tsujii,
  • Yoshito Hayashi,
  • Takahiro Inoue,
  • Hideki Iijima,
  • Tetsuo Takehara

DOI
https://doi.org/10.1038/s41598-022-09455-8
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 9

Abstract

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Abstract The outcomes of patients with elderly onset (EO) inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor (TNF) remains uncertain. The present study evaluated the efficacy and safety of anti-TNF treatment for bio-naïve EO-IBD. Elderly patients were defined as those 60 years and older, and further divided into those with EO (Elderly-EO) and those with non-elderly onset (Elderly-NEO). A total of 432 bio-naïve patients were enrolled in this multicenter observational study, comprising 55 with Elderly-EO (12.7%), 25 with Elderly-NEO (5.8%), and 352 under age 60 (Non-elderly, 81.5%). After 52 weeks of anti-TNF treatment, clinical and steroid-free remission rates were significantly lower in Elderly-EO than in Non-elderly (37.7% and 60.8%; P = 0.001, and 35.9% and 57.8%; P = 0.003, respectively), and comparable between Elderly-NEO and Non-elderly. Multivariate analysis revealed that elderly onset was a significant factor for both clinical remission (OR, 0.49, 95% CI 0.25–0.96) and steroid-free remission (OR, 0.51, 95% CI 0.26–0.99) after 52 weeks of anti-TNF treatment. The rate of cumulative severe adverse events was significantly higher in Elderly-EO than in Non-elderly (P = 0.007), and comparable between Elderly-NEO and Non-elderly. In conclusion, anti-TNF treatment for bio-naïve EO-IBD may be less effective and raise safety concerns.