Article Text

PDF
Original article
Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study
  1. Cloé Charpentier1,
  2. Julia Salleron2,
  3. Guillaume Savoye1,
  4. Mathurin Fumery3,
  5. Véronique Merle4,
  6. Jean-Eric Laberenne5,
  7. Francis Vasseur2,
  8. Jean-Louis Dupas3,
  9. Antoine Cortot6,
  10. Luc Dauchet7,
  11. Laurent Peyrin-Biroulet8,
  12. Eric Lerebours1,
  13. Jean-Frédéric Colombel6,9,
  14. Corinne Gower-Rousseau7
  1. 1Gastroenterology Unit, EPIMAD Registry, Rouen University and Hospital, Rouen, France
  2. 2Biostatistics Unit, EA 2694, University Lille Nord de France, CHU Lille and Lille-2 University, Lille Cédex, France
  3. 3Gastroenterology Unit, EPIMAD Registry, Amiens Hospital and University, Amiens, France
  4. 4Epidemiology Unit, EPIMAD Registry, Rouen University and Hospital, Lille, France
  5. 5Gastroenterology Unit, EPIMAD Registry, Seclin Hospital, Seclin, France
  6. 6Gastroenterology Unit, University Lille Nord de France, CHU Lille and Lille-2 University, Lille, France
  7. 7Epidemiology Unit, EPIMAD Registry, EA 2694, University Lille Nord de France, CHU Lille and Lille-2 University, Lille, France
  8. 8Gastroenterology Unit, Inserm U954, Nancy University and Hospital, Allée du Morvan, France
  9. 9Division of Gastroenterology, Mount Sinai Medical Center and Mount Sinai School of Medicine, New York, USA
  1. Correspondence to Professor Jean-Frédéric Colombel, Gastroenterology Unit, EPIMAD Registry, Hôpital Huriez, CH et U de Lille, 59037 Lille Cedex, France; jean-frederic.colombel{at}mssm.edu; jean-frederic.colombel{at}chru-lille.fr

Abstract

Data on the natural history of elderly-onset inflammatory bowel disease (IBD) are scarce.

Methods In a French population-based cohort we identified 841 IBD patients >60 years of age at diagnosis from 1988 to 2006, including 367 Crohn's disease (CD) and 472 ulcerative colitis (UC).

Results Median age at diagnosis was similar for CD (70 years (IQR: 65–76)) and UC (69 years (64–74)). Median follow-up was 6 years (2–11) for both diseases. At diagnosis, in CD, pure colonic disease (65%) and inflammatory behaviour (78%) were the most frequent phenotype. At maximal follow-up digestive extension and complicated behaviour occurred in 8% and 9%, respectively. In UC, 29% of patients had proctitis, 45% left-sided and 26% extensive colitis without extension during follow-up in 84%. In CD cumulative probabilities of receiving corticosteroids (CSs), immunosuppressants (ISs) and anti tumor necrosis factor therapy were respectively 47%, 27% and 9% at 10 years. In UC cumulative probabilities of receiving CS and IS were 40% and 15%, respectively at 10 years. Cumulative probabilities of surgery at 1 year and 10 years were 18% and 32%, respectively in CD and 4% and 8%, respectively in UC. In CD complicated behaviour at diagnosis (HR: 2.6; 95% CI 1.5 to 4.6) was associated with an increased risk for surgery while CS was associated with a decreased risk (HR: 0.5; 0.3 to 0.8). In UC CS was associated with an increased risk (HR: 2.2; 1.1 to 4.6) for colectomy.

Conclusions Clinical course is mild in elderly-onset IBD patients. This information would need to be taken into account by physicians when therapeutic strategies are established.

  • Inflammatory Bowel Disease
  • Elderly
  • Epidemiology

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.