- Fecal Incontinence
|Older Adult Patients Use More Aminosalicylate Monotherapy Compared With Younger Patients With Inflammatory Bowel Disease: TARGET-IBD
J Clin Gastroenterol. 2022 Jul 1;56(6):529-535.doi: 10.1097/MCG.0000000000001557. Epub 2021 Jun 11.
1Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill.
2Atrium Health Gastroenterology and Hepatology, Charlotte.
3Department of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, OH.
4Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
5Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai.
6IBD Center, The University of Chicago Medicine, Chicago, IL.
7Division of Pediatric Gastroenterology, The Susan & Leonard Feinstein IBD Clinical Center at Icahn School of Medicine at Mount Sinai, New York, NY.
8Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
9Target RWE, Health Evidence Solutions, Durham, NC.
Goal: The goal of this study was to describe medication utilization patterns in older inflammatory bowel disease (IBD) patients.
Background: Despite a growing population of older patients with Crohn's disease (CD) and ulcerative colitis (UC), questions remain regarding medication utilization patterns in comparison to younger populations.
Materials and methods: We collected data from the 34 sites in TARGET-IBD, a multicenter, observational cohort. The primary outcome in this study was the IBD-specific therapy utilized among older patients with IBD compared with younger age groups. Therapy use was analyzed using pairwise comparisons and then the odds of IBD-specific therapy use among patients older than age 65 were evaluated using multivariable logistic regression models.
Results: We identified 2980 patients with IBD (61% CD). In multivariable analysis, younger patients with UC were significantly less likely to utilize aminosalicylate monotherapy when compared with patients above 65 years [age 18 to 29: adjusted odds ratio (aOR)=0.51, 95% confidence interval (CI): 0.33-0.78]. In patients with CD, younger patients were significantly less likely to use aminosalicylate monotherapy when compared with patients above 65 (greatest difference age 18 to 29: aOR=0.31, 95% CI: 0.18-0.52). Younger patients with CD and UC were significantly more likely to use anti-tumor necrosis factor monotherapy than patients above 65 years (age 18 to 29: aOR=3.87, 95% CI: 2.47-6.06 and aOR=2.68, 95% CI: 1.29-5.58, respectively).
Conclusions: Older patients with IBD demonstrate significant differences in medication utilization, including more aminosalicylate monotherapy and less anti-tumor necrosis factor monotherapy compared with younger age groups. Given the aging population in the United States, these utilization patterns may have long-term implications for disease control.