Clinical characteristics of ulcerative colitis in elderly patients

Abstract

The incidence of ulcerative colitis (UC) in elderly patients is increasing. Elderly UC patients are likely to exhibit distinct features both at diagnosis and during follow‐up. Age‐related problems, including complications, immune dysfunction, and multidrug use, make the diagnosis and treatment of elderly UC more challenging. Suboptimal treatment considering adverse events leads to poor clinical outcome in elderly UC patients. Here, we reviewed the epidemiology, clinical presentation, medical therapy, colorectal cancer surveillance of UC in elderly patients.

User's guide to JAK inhibitors in inflammatory bowel disease

“…However, this risk was similar between age groups in the tofacitinib 5 ​mg BID and adalimumab groups. These results suggest an effect modification by age for tofacitinib 10 ​mg BID ( Zhu and Ran, 2021 ; Winthrop et al., 2021b ). In the post-marketing safety study on tofacitinib in RA, older patients (≥50 years) and with ≥1 cardiovascular risk factor were identified as having a higher frequency of PE and all-cause mortality when receiving tofacitinib 10 ​mg BID versus those receiving anti-TNF agent ( Safety Study of Tofacitin, 2092 ; Zhu and Ran, 2021 ).…”

“…These results suggest an effect modification by age for tofacitinib 10 ​mg BID ( Zhu and Ran, 2021 ; Winthrop et al., 2021b ). In the post-marketing safety study on tofacitinib in RA, older patients (≥50 years) and with ≥1 cardiovascular risk factor were identified as having a higher frequency of PE and all-cause mortality when receiving tofacitinib 10 ​mg BID versus those receiving anti-TNF agent ( Safety Study of Tofacitin, 2092 ; Zhu and Ran, 2021 ). RCT and real-world data regarding safety risks in elderly patients with UC receiving tofacitinib are still being collected and analyzed.…”

Elderly Patients with Moderate-To-Severe Ulcerative Colitis Are More Likely to Have Treatment Failure and Adverse Outcome

“…For medical treatment, as an initial option, 5-ASA was always the most common treatment for both the elderly and adult UC patients [10]. In the patients who were treated with 5-ASAs at the beginning of admission, the response to 5-ASAs in the elderly did not present a sig- nificant difference compared to adult patients.…”

“…Most patients with moderate-to-severe disease activity required to hospitalize for evaluation and treatment. 5-Aminosalicylic acids (5-ASAs) are the most commonly used medications for elderly UC patients as its perceived safety advantages [10]. So for initial onset patients, 5-ASAs are still usually given first, and meanwhile, disease assessment is performed, after which treatment escalation (steroids, immunomodulators, or biologics) is considered in our center.…”