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老年发病的炎症性肠病具有独特的疾病特征和治疗模式
Maya Granot1,2, Uri Kopylov2,3, Yael Talmor2,4
1Division of Pediatric Gastroenterology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
United European gastroenterology journal
|August 7, 2025
概括
老年发病的炎症性肠病 (IBD) 呈现出更多的仅结肠参与和不那么积极的表型. 在老年人中,治疗有利于5-ASA,减少生物使用,并优先选择Vedolizumab而不是抗TNFs.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 临床流行病学临床流行病学
背景情况:
- 老年发病的炎症性肠病 (IBD),在60岁或以上被诊断出来,具有独特的临床特征.
- 了解这些差异对于优化患者护理和治疗策略至关重要.
研究的目的:
- 为了比较成人发病 (18-59岁) 和老年发病 (≥60岁) IBD 患者之间的疾病表型和治疗暴露.
- 在老年人群中识别IBD的独特特征.
主要方法:
- 一项基于现实生活的注册表的队列研究,比较了2000-2022年间诊断的成人和老年IBD患者.
- 分析包括人口统计,疾病特征 (参与,表型,并发症) 和治疗暴露 (药物,手术).
- 随访持续时间至少为12个月.
主要成果:
- 老年人发病的IBD (9%的队列) 显示,仅结肠参与的患病率更高,包括性结肠炎 (UC) 和结肠L2克罗恩病 (CD).
- 与成人发病的CD相比,老年发病的CD表现出较少的胆结直肠L3疾病,较少的B3表型透,以及较少的周围卷入.
- 老年发病患者接受了更多的5-ASA,但显著减少了生物药物/JAK抑制剂,显示出更高的15年无生物药物生存率. 作为一线生物药物,维多利祖马布比抗TNFs更受青.
- 两组之间没有观察到IBD相关手术或类固醇使用的显著差异.
结论:
- 老年人发病的IBD的特点是,只有结肠疾病 (UC和L2CD) 的患病率更高.
- 对老年人发病的IBD的治疗方法优先考虑5-ASA,并减少生物药物的使用.
- 在老年IBD患者中,维多利祖马布似乎是一个比抗TNFs更喜欢的生物药物.
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