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Disease patterns in late-onset ulcerative colitis: Results from the IG-IBD "AGED study"
Walter Fries1, Anna Viola1, Natalia Manetti2
1Clinical Unit for Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Summary
Late-onset ulcerative colitis (UC) can present aggressively in nearly half of elderly patients. Despite similar steroid and surgery rates, older adults receive fewer immunomodulators and biologics.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Background:
- Late-onset ulcerative colitis (UC) poses a growing clinical challenge.
- Outcomes and treatment strategies for elderly UC patients are understudied.
Purpose of the Study:
- To define the natural history of late-onset UC.
- To compare disease presentation and course across age groups.
Main Methods:
- Multicenter retrospective study of 1091 UC patients.
- Analysis of disease patterns, therapies, and outcomes in the first 3 years.
- Stratification into three age groups: ≥65, 40-64, and <40 years.
Main Results:
- 44% of late-onset UC patients exhibit chronic active or relapsing disease.
- Elderly patients receive fewer immunomodulators and biologics.
- Advanced age and comorbidities inversely correlate with advanced therapy use, but not surgery.
Conclusions:
- Late-onset UC is not uniformly mild; a significant subset has aggressive disease.
- Lower use of immunosuppressants and biologics in the elderly may stem from prescribing concerns.
- Further research is needed to optimize treatment for elderly UC patients.
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