Aminosalicylate use more common among older than younger IBD patients

Use of medication is markedly different among older patients with inflammatory bowel disease (IBD), with more aminosalicylate monotherapy and less antitumour necrosis factor monotherapy than younger patients, according to a US study.

A team of investigators obtained data from 34 sites in the TARGET-IBD, a multicentre, observational cohort. IBD-specific therapy utilized among older vs younger IBD patients was the primary outcome. Pairwise comparisons were used to analyse therapy use, while the odds of IBD-specific therapy use among patients aged >65 years were assessed using multivariable logistic regression models.

A total of 2,980 patients with IBD were included, of whom 61 percent had Crohn’s disease (CD). Multivariate analysis revealed that younger patients with ulcerative colitis (UC) were significantly less likely to use aminosalicylate monotherapy compared to those aged >65 years (adjusted odds ratio [aOR], 0.51, 95 percent confidence interval [CI], 0.33‒0.78).

Likewise, younger CD patients were significantly less likely to utilize aminosalicylate monotherapy relative to those aged >65 years (greatest difference age 18‒29: aOR, 0.31, 95 percent CI, 0.18‒0.52).

On the other hand, younger patients with CD and UC were significantly more likely to use antitumour necrosis factor monotherapy than those aged >65 years (age 18‒29: aOR, 3.87, 95 percent CI, 2.47‒6.06 and aOR, 2.68, 95 percent CI, 1.29‒5.58, respectively).

“Given the ageing population in the United States, these utilization patterns may have long-term implications for disease control,” the investigators said.