W1276 Patterns of Medical Treatment and Polypharmacy in Geriatric Crohn's Disease

Time to clinical response and remission for therapeutics in inflammatory bowel diseases: What should the clinician expect, what should patients be told?

“…While several additional factors intuitively could affect time to therapeutic response such as nutritional status, age and the intestinal microbiome, published data are lacking. Advancing age is typically associated with a reduced glomerular filtration rate, greater oxidative stress, increased volume of distribution, co-morbid conditions, decreased hepatic metabolism and frailty-any of which may affect treatment choice and a therapy’s time to clinical response[ 141 , 142 ]. For instance, one retrospective study found that rates of clinical response to anti-TNF therapy for IBD in patients > 65 years was significantly less at week 10 but not significantly different at 6 mo than matched controls with similar co-morbidities aged < 65 years, suggesting a slower onset of response overall[ 143 ].…”

Enfermedad inflamatoria intestinal en pacientes mayores de 60 años: ¿es una enfermedad diferente?

“…La presencia de eventos adversos no presentó diferencias significativas entre los grupos. En consecuencia, en nuestra opinión las estrategias farmacológicas no deben ser modificadas como resultado de la edad del paciente, destacando que la subutilización de estos fármacos puede estar asociada a un mal control de la enfermedad en la población geriátrica 32 . Pese a esto, se debe tener presente los cambios fisiológicos en la biodisponibilidad de los esteroides 33 , ya que ellos pueden aumentar los eventos adversos en este grupo etario 34 .…”