Abstract
Background
Late-onset UC represents an important issue for the near future, but its outcomes
and relative therapeutic strategies are yet poorly studied.
Aim
To better define the natural history of late-onset ulcerative colitis.
Methods
In a multicenter retrospective study, we investigated the disease presentation and
course in the first 3 years in 1091 UC patients divided into 3 age-groups: diagnosis
≥65 years, 40–64 years, and <40 years. Disease patterns, medical and surgical therapies, and risk factors for disease
outcomes were analyzed.
Results
Chronic active or relapsing disease accounts for 44% of patients with late-onset UC.
Across all age-groups, these disease patterns require 3–6 times more steroids than
remitting disease, but immunomodulators and, to a lesser extent, biologics are less
frequently prescribed in the elderly. Advanced age, concomitant diseases and related
therapies were found to be inversely associated with the use of immunomodulators or
biologics, but not with surgery.
Conclusions
The conclusion that late-onset UC follows a mild course may apply only to a subset
of patients. an important percentage of elderly patients present with more aggressive
disease. Since steroid use and surgery rates did not differ in this subgroup, lower
use of immunosuppressive therapy and biologics may reflect concerns in prescribing
these therapies in the elderly.
Keywords
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Article info
Publication history
Published online: October 04, 2016
Accepted:
September 11,
2016
Received in revised form:
August 13,
2016
Received:
May 1,
2016
Identification
Copyright
© 2016 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
