Anti-TNF weaker against elderly-onset IBD

Anti-tumour necrosis factor (TNF) treatment appears to be less effective in elderly-onset inflammatory bowel disease (EO-IBD), a recent study has found.

This multicentre observational study included 432 bio-naïve IBD patients. Fifty-five were elderly and had EO-IBD (elderly-EO group), while 25 were elderly but whose IBD onset occurred at a younger age (elderly-NEO group); the remaining 352 patients were non-elderly. Participants underwent 52 weeks of anti-TNF treatment after which clinical and steroid-free remission rates were assessed.

At the final follow-up, clinical remission rate was significantly lower in the elderly-EO vs non-elderly group (37.7 percent vs 60.8 percent; p=0.001). No such difference was observed, however, when comparing against the elderly-NEO group.

Steroid-free remission rate was likewise significantly worse in the elderly-EO group than in non-elderly patients (35.9 percent vs 57.8 percent; p=0.003) but not in elderly-NEO counterparts.

Of note, EO-IBD also significantly worsened the efficacy of anti-TNF treatment in the short-term. Eight weeks after treatment, clinical (50.0 percent vs 67.8 percent; p=0.026) and steroid-free (36.5 percent vs 60.6 percent; p=0.002) remission rates were already significantly lower in elderly-EO patients than in non-elderly comparators. No such difference was reported for elderly-NEO comparisons.

Multivariate analysis confirmed that EO was an independent, inverse, and significant correlate of clinical (odds ratio [OR], 0.49, 95 percent confidence interval [CI], 0.25–0.96; p=0.04) and steroid-free (OR, 0.51, 95 percent CI, 0.26–0.99; p=0.048) remission.