Award: Presidential Poster Award
Edward L. Barnes, MD, MPH1, John Hanson, MD2, Miguel Regueiro, MD, FACG3, Sumona Saha, MD, MPH4, Bruce E. Sands, MD, FACG5, David T. Rubin, MD, FACG6, Marla C. Dubinsky, MD5, Corey A. Siegel, MD, MS7, Derek R. Gazis, MS8, Julia M. Crawford, MD8, Millie D. Long, MD, MPH, FACG9
1University of North Carolina, Chapel Hill, NC; 2Atrium Digestive Health, Charlotte, NC; 3Cleveland Clinic Foundation, Cleveland, OH; 4University of Wisconsin School of Medicine & Public Health, Madison, WI; 5Icahn School of Medicine at Mount Sinai, New York, NY; 6Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL; 7Dartmouth-Hitchcock Medical Center, Hanover, NH; 8TARGET PharmaSolutions, Durham, NC; 9University of North Carolina, Center for Gastrointestinal Biology and Disease, Chapel Hill, NC
Introduction: As compared to younger patients, much less is known regarding inflammatory bowel disease (IBD)-related medications in elderly ( > 65 years) patients. This analysis uses a large cohort of patients with IBD to describe the distribution of patient characteristics and patterns of medication use.
Methods: TARGET-IBD is a longitudinal cohort of patients with IBD receiving usual care at community and academic practices in the US. Patients with IBD enrolled between July 2017 and May 2019 were included in this analysis. The prevalence of medication use by drug class at the time of enrollment among patients with both ulcerative colitis (UC) and Crohn's disease (CD) was estimated. Age was stratified into the following categories: > 30, 30-49, 50-65 and > 65 years. Proportions and means of patient characteristics were compared using tests of association. The odds of biologic use at enrollment was modeled as was the 95% CI by patient characteristics using logistics regression.
Results: 681 patients with UC and 979 patients with CD were included in the analysis. At enrollment, mesalamine was the most common medication used among patients with CD > 65 years (34%) and among patients with UC across all age categories (58%-77%, Table 1). Use of mesalamine generally increased with advancing age. Patients with CD > 65 years were more than twice as likely to be users of mesalamine at enrollment than patients < 30 years (p< 0.0001). Among patients with either disease type, anti-tumor necrosis factor alpha (anti-TNF) use decreased in patients > 65 years compared to patients < 30 years. Thiopurine use did not vary across age categories. Among patients > 65 at enrollment, use of a 5-ASA derivative, anti-TNF, steroid or thiopurine did not differ by established and newly diagnosed patients. There was no association between age, type of IBD, insurance, gender, race or cardiovascular disease and the odds of biologic use in patients > 65 years (Figure 1).
Discussion: Elderly patients with IBD, whether those with new diagnoses or individuals with longstanding disease make up a substantial portion of the IBD population. Given that elderly patients demonstrate significant differences in medication use patterns compared to younger patients with IBD, studies of efficacy and adverse events specific to this population are warranted.
Citation: Edward L. Barnes, MD, MPH; John Hanson, MD; Miguel Regueiro, MD, FACG; Sumona Saha, MD, MPH; Bruce E. Sands, MD, FACG; David T. Rubin, MD, FACG; Marla C. Dubinsky, MD; Corey A. Siegel, MD, MS; Derek R. Gazis, MS; Julia M. Crawford, MD; Millie D. Long, MD, MPH, FACG. P1394 - MEDICATION USE AND COMORBIDITIES AMONG ELDERLY AS COMPARED TO YOUNGER PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN THE TARGET-IBD COHORT. Program No. P1394. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.