Biological Therapy in the Elderly with Inflammatory Bowel Disease: Narrative Review
Published
Jan 24, 2024
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Erika Geraldine Guarín Navas
https://orcid.org/0000-0003-3177-1046
Claudia Patricia Zuluaga Serna
https://orcid.org/0000-0003-3595-3875
https://orcid.org/0000-0003-3177-1046
Claudia Patricia Zuluaga Serna
https://orcid.org/0000-0003-3595-3875
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Abstract
The aging population with inflammatory bowel disease has increased in incidence. A cut-off point is taken for age; in which it is defined that those ≥ 60 years are considered older adults in the context of IBD. The aspects to highlight and that contribute to significant differences in the treatment of the elderly are the lack of evidence in the literature, the little experience of the use of biological therapies in this age group, the extrapolation of the available information, and the need for include comprehensive geriatric assessment with subsequent identification and management of geriatric syndromes within the overall treatment of IBD. Biological therapy in IBD in the elderly has no differences with general population in terms of indication, however, there are some special considerations related with the safety and efficacy profile and the impact on the geriatric domains (clinical, functional, cognitive and social).
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References
1. Rodríguez-D’Jesus A, Casellas F, Malagelada JR. Epidemiología de la enfermedad inflamatoria intestinal en el paciente de edad avanzada. Gastroenterol Hepatol. 2008;31(5):269-73. https://doi.org/10.1157/13119877
2. Klein A, Chowers Y, Eliakim R. Inflammatory bowel disease in the elderly. Gastrointest Tract Aged. 2013;151-80.
3. Hong SJ, Katz S. The elderly IBD patient in the modern era: changing paradigms in risk stratification and therapeutic management. Therap Adv Gastroenterol. 2021;14:1-15.
4. Bonovas S, Pantavou K, Evripidou D, Bastiampillai AJ, Nikolopoulos GK, Peyrin-Biroulet L, et al. Safety of biological therapies in ulcerative colitis: an umbrella review of meta-analyses. Best Pract Res Clin Gastroenterol. 2018;32-33:43-7. https://doi.org/10.1016/j.bpg.2018.05.005
5. Tran V, Limketkai BN, Sauk JS. IBD in the elderly: management challenges and therapeutic considerations. Curr Gastroenterol Rep. 2019;21(11). https://doi.org/10.1007/s11894-019-0720-7
6. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146-57. https://doi.org/10.1093/gerona/56.3.m146
7. Ananthakrishnan AN, Nguyen GC, Bernstein CN. AGA clinical practice update on management of inflammatory bowel disease in elderly patients: expert review. Gastroenterology. 2021;160(1):445-51. https://doi.org/10.1053/j.gastro.2020.08.060
8. Asscher VER, Waars SN, van der Meulen-de Jong AE, Stuyt RJL, Baven-Pronk AMC, van der Marel S, et al. Deficits in geriatric assessment associate with disease activity and burden in older patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2022;20(5):e1006-21. https://doi.org/10.1016/j.cgh.2021.06.015
9. Juliao-Baños F, Puentes F, López R, Saffon MA, Reyes G, Parra V, et al. Characterization of inflammatory bowel disease in Colombia: results of a national register. Rev Gastroenterol Mex. 2021;86(2):153-62. https://doi.org/10.1016/j.rgmx.2020.05.005
10. Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut. 2005;54(8):1121-5.
11. U. S. Food and Drug Administration. FDA approves Inflectra, a biosimilar to Remicade [internet]. FDA; 2014 [citado 2023 jul 11]. Disponible en: https://www.fda.gov/news-events/press-announcements/fda-approves-inflectra-biosimilar-remicade
12. U. S. Food and Drug Administration. NDA/BLA multi-disciplinary review and evaluation BLA 125433, supplement 30 IV Golimumab (Simponi Aria) [internet]. FDA. [Citado 2023 jul 11]. Disponible en: https://www.fda.gov/media/143318/download
13. U. S. Food and Drug Administration. FDA Approves Cyltezo, the first interchangeable biosimilar to Humira: Second Interchangeable Biosimilar Product Approved by Agency [internet]. FDA; 2021 oct 18 [citado 2023 jul 11]. Disponible en: https://www.fda.gov/news-events/press-announcements/fda-approves-cyltezo-first-interchangeable-biosimilar-humira
14. De Jong ME, Smits LJT, Van Ruijven B, Den Broeder N, Russel MGVM, Römkens TEH, et al. Increased discontinuation rates of anti-TNF therapy in elderly inflammatory bowel disease patients. J Crohn’s Colitis. 2020;14(7):888-95.
15. Porcari S, Viola A, Orlando A, Privitera AC, Ferracane C, Cappello M, et al. Persistence on anti-tumour necrosis factor therapy in older patients with inflammatory bowel disease compared with younger patients: data from the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD). Drugs Aging. 2020;37(5):383-92. https://doi.org/10.1007/s40266-020-00744-3
16. U. S. Food and Drug Administration. Drug trials snapshot: Entyvio (vedolizumab) to treat ulcerative colitis [internet]. FDA. [Citado 2023 jul 11]. Disponible en: https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshot-entyvio-vedolizumab-treat-ulcerative-colitis
17. Mayo T, Py T, Serious D, Oi N. Abstracts [731]. 2017;112(October):2016-7.
18. Kochar B, Pate V, Kappelman MD, Long MD, Ananthakrishnan AN, Chan AT, et al. Vedolizumab is associated with a lower risk of serious infections than anti-tumor necrosis factor agents in older adults. Clin Gastroenterol Hepatol [Internet]. 2021;20(6):1299-1305.e5. https://doi.org/10.1016/j.cgh.2021.08.047
19. Davis R, McParland P, Dodd S, Storey D, Probert C, Collins P, et al. Comparative effectiveness of antitumour necrosis factor agents and vedolizumab in ulcerative colitis. Eur J Gastroenterol Hepatol. 2019;31(6):661-7.
20. Verstockt B, Claeys C, De Hertogh G, Van Assche G, Wolthuis A, D’Hoore A, et al. Outcome of biological therapies in chronic antibiotic-refractory pouchitis: a retrospective single-centre experience. United Eur Gastroenterol J. 2019;7(9):1215-25.
21. Amiot A, Serrero M, Peyrin-Biroulet L, Filippi J, Pariente B, Roblin X, et al. One-year effectiveness and safety of vedolizumab therapy for inflammatory bowel disease: a prospective multicentre cohort study. Aliment Pharmacol Ther. 2017;46(3):310-21.
22. Paul S, Roblin X. Letter: immunogenicity of anti-TNF in elderly IBD patients. Aliment Pharmacol Ther. 2019;50(3):336.
23. Bressler B, Yarur A, Silverberg MS, Bassel M, Bellaguarda E, Fourment C, et al. Vedolizumab and anti-tumour necrosis factor α real-world outcomes in biologic-naïve inflammatory bowel disease patients: results from the EVOLVE Study. J Crohn’s Colitis. 2021;15(10):1694-706.
24. Shashi P, Gopalakrishnan D, Parikh MP, Shen B, Kochhar G. Efficacy and safety of vedolizumab in elderly patients with inflammatory bowel disease: a matched case-control study. Gastroenterol Rep. 2020;8(4):306-11. https://doi.org/10.1093/gastro/goz041
25. Khan N, Pernes T, Weiss A, Trivedi C, Patel M, Medvedeva E, et al. Efficacy of vedolizumab in a nationwide cohort of elderly inflammatory bowel disease patients. Inflamm Bowel Dis. 2021;(July):1-11. https://doi.org/10.1093/ibd/izab163
26. Hupé M, Rivière P, Nancey S, Roblin X, Altwegg R, Filippi J, et al. Comparative efficacy and safety of vedolizumab and infliximab in ulcerative colitis after failure of a first subcutaneous anti-TNF agent: a multicentre cohort study. Aliment Pharmacol Ther. 2020;51(9):852-60. https://doi.org/10.1111/apt.15680
27. U. S. Food and Drug Administration. Stelara (Ustekinumba) [internet]. FDA; 2019 [citado 2023 jul 11]. Disponible en: https://www.fda.gov/media/108945/download
28. Kalb RE, Fiorentino DF, Lebwohl MG, Toole J, Poulin Y, Cohen AD, et al. Risk of serious infection with biologic and systemic treatment of psoriasis: results from the psoriasis longitudinal assessment and registry (PSOLAR). JAMA Dermatol. 2015;151(9):961-9. https://doi.org/10.1001/jamadermatol.2015.0718
29. Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel J-F, Sandborn WJ, et al. Vedolizumab as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2013;369(8):699-710.
30. U. S. Food and Drug Administration. FDA approves Boxed Warning about increased risk of blood clots and death with higher dose of arthritis and ulcerative colitis medicine tofacitinib (Xeljanz, Xeljanz XR) [internet]. FDA. [Citado 2023 jul 11]. Disponible en: https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-approves-boxed-warning-about-increased-risk-blood-clots-and-death-higher-dose-arthritis-and
31. Gisbert JP, Chaparro M. Systematic review with meta-analysis: inflammatory bowel disease in the elderly. Aliment Pharmacol Ther. 2014;39(5):459-77.
32. Kochar B, Orkaby AR, Ananthakrishnan AN, Ritchie CS. Frailty in inflammatory bowel diseases: an emerging concept. Therap Adv Gastroenterol. 2021;14:1-12.
33. Segal JP, Htet HMT, Limdi J, Hayee B. How to manage IBD in the “elderly”. Frontline Gastroenterol. 2020;11(6):468-77. https://doi.org/10.1136/flgastro-2019-101218
34. Beaugerie L, Kirchgesner J. Balancing benefit vs risk of immunosuppressive therapy for individual patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2019;17(3):370-9. https://doi.org/10.1016/j.cgh.2018.07.013
How to Cite
Guarín Navas, E. G., & Zuluaga Serna, C. P. (2024). Biological Therapy in the Elderly with Inflammatory Bowel Disease: Narrative Review. Universitas Medica, 64(4). https://doi.org/10.11144/Javeriana.umed64-4.tbei
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