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Comparison of Disease Phenotype and Course Among Elderly- and Early-Onset Inflammatory Bowel Diseases in the Middle East Publisher Pubmed



Vosoghinia H1 ; Saberzadehardestani B2 ; Anushiravani A2 ; Mansourghanaei F3 ; Fakheri H4 ; Vahedi H2 ; Sheikhesmaeili F5 ; Yazdanbod A6 ; Moosavy SH7 ; Maleki I4 ; Nasserimoghaddam S2 ; Khosravi B2 ; Malekzadeh M2 ; Kasaeian A2, 8 Show All Authors
Authors
  1. Vosoghinia H1
  2. Saberzadehardestani B2
  3. Anushiravani A2
  4. Mansourghanaei F3
  5. Fakheri H4
  6. Vahedi H2
  7. Sheikhesmaeili F5
  8. Yazdanbod A6
  9. Moosavy SH7
  10. Maleki I4
  11. Nasserimoghaddam S2
  12. Khosravi B2
  13. Malekzadeh M2
  14. Kasaeian A2, 8
  15. Alatab S2
  16. Sadeghi A2
  17. Kolahdoozan S2
  18. Amani M2
  19. Saberhosseini SN9
  20. Rayatpisheh M2
  21. Ahadi M9
  22. Colombel JF10
  23. Ungaro RC10
  24. Sima AR2, 11
  25. Malekzadeh R2
Show Affiliations
Authors Affiliations
  1. 1. Gastroenterology and Hepatology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
  2. 2. Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
  4. 4. Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  5. 5. Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  6. 6. Gastroenterology and Hepatology Department, Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  7. 7. Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  8. 8. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Mashhad University of Medical Sciences, Mashhad, Iran
  10. 10. The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, United States
  11. 11. Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Center, Tehran, Iran

Source: Archives of Iranian Medicine Published:2023


Abstract

Background: It is unknown if the clinical manifestations and phenotype of disease are comparable between early- and elderly-onset inflammatory bowel disease (IBD). We aimed to seek differences in disease phenotype, course, complications, and treatment between early- and elderly-onset IBD patients. Methods: This retrospective cohort study on registered IBD patients in the Iranian Registry of Crohn’s and Colitis (IRCC) compared demographics, disease phenotype, disease activity, IBD-related surgery and medications between early- and elderly-onset IBD. A generalized linear regression model was used to investigate the relative risk of age at diagnosis adjusted for gender and disease duration for the outcomes. Results: From 10 048 IBD patients, 749 with early-onset (7.5%), and 472 (4.7%) elderly-onset IBD were enrolled: 855 (63.1%) ulcerative colitis (UC) and 366 (26.9%) Crohn’s disease (CD). Left-sided colitis was more frequent among elderly-onset UC patients (P< 0.001). Ileum and ileocolonic locations were the most common types in elderly-onset and early-onset CD patients, respectively. In comparison with elderly-onset UC, early-onset cases more often used prednisolone (22.1% vs. 11.4%, P= 0.001), immunomodulators (44.9% vs 25.2%, P< 0.001) and anti-tumor necrosis factors (TNF) (20.1% vs 11.9%, P= 0.002). Elderly-onset UC patients had 0.7 times lower risk of aggressive phenotype (95%CI:0.6‒0.9, P= 0.005). Early-onset CD was associated with higher use of prednisolone (27.7% vs 8.1%, P< 0.001), immunomodulators (58.7% vs 41.8%, P= 0.005) and anti-TNF (49.6% vs 35.4%, P= 0.006). Conclusion: Early-onset IBD was associated with a more aggressive phenotype and higher prednisolone, immunomodulators, and anti-TNF use. © 2023 Academy of Medical Sciences of I.R. Iran. All rights reserved.
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