Safety and Effectiveness of Vedolizumab and Ustekinumab in Elderly Patients with Inflammatory Bowel Disease : A Real-Life Multicentric Cohort Study
Holvoet, Tom (Ghent University)
Truyens, Marie (Ghent University)
De Galan, Cara (Ghent University)
Peeters, Harald (Sint Lucas Andreas Ziekenhuis (Amsterdam, Països Baixos))
Mesonero, Francisco (Hospital Universitario Ramón y Cajal (Madrid))
Elorza, Ainara (Hospital de Galdakao (Usansolo, Biscaia))
Torres, Paola (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vandermeulen, Liv (Universitair Ziekenhuis Brussel)
Jauregui-Amezaga, Aranzazu (University Hospital Antwerp)
Ferreiro-Iglesias, Rocio (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Zabana, Yamile (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Peries Reverter, Laia (Hospital Universitari de Girona Doctor Josep Trueta)
Geldof, Jeroen (Ghent University)
Lobatón, Triana (Ghent University)

Data:	2024
Resum:	Background: Data on ustekinumab and vedolizumab in the elderly inflammatory bowel disease (IBD) population are limited. The aim of the current study was to assess the safety and effectiveness of both in an elderly real-life population. Methods: A multicentric retrospective study was performed on IBD patients who started vedolizumab or ustekinumab between 2010 and 2020. Clinical and endoscopic remission rates and (serious) adverse events (AE) were assessed. Results: A total of 911 IBD patients were included, with 171 (19%) aged above 60 (111 VDZ, 60 UST). Elderly patients treated with vedolizumab or ustekinumab had an increased risk for non-IBD hospitalization (10. 5% vs. 5. 7%, p = 0. 021) and malignancy (2. 3% vs. 0. 5%, p = 0. 045) compared to the younger population. Corticosteroid-free clinical (50% vs. 44%; p = 0. 201) and endoscopic remission rates (47. 9% vs. 31%, p = 0. 07) at 1 year were similar. Comparing vedolizumab to ustekinumab in the elderly population, corticosteroid-free (47. 9% vs. 31%, p = 0. 061) and endoscopic remission rates (66. 7% vs. 64. 4%, p = 0. 981) were similar. Vedolizumab- and ustekinumab-treated patients had comparable infection rates (13. 5% vs. 10. 0%, p = 0. 504), IBD flare-ups (4. 5% vs. 5%, p = 1. 000), the occurrence of new EIMs (13. 5% vs. 10%, p = 0. 504), a risk of intestinal surgery (5. 4% vs. 6. 7%, p = 0. 742), malignancy (1. 8% vs. 3. 3%, p = 0. 613), hospitalization (9. 9% vs. 11. 7%, p = 0. 721), and mortality (0. 9% vs. 1. 7%, p = 1. 000). AE risk was associated only with corticosteroid use. Conclusions: Ustekinumab and vedolizumab show comparable effectiveness and safety in the elderly IBD population. Elderly IBD patients have an increased risk for non-IBD hospitalizations and malignancy compared to the younger IBD population, with corticosteroid use as the main risk factor.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Elderly ; IBD ; Vedolizumab ; Ustekinumab ; Safety
Publicat a:	Journal of clinical medicine, Vol. 13 Núm. 2 (January 2024) , p. 365, ISSN 2077-0383

DOI: 10.3390/jcm13020365
PMID: 38256499

12 p, 1.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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