Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease
World Journal of Gastroenterology, cilt.32, sa.27, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 27
- Basım Tarihi: 2026
- Doi Numarası: 10.3748/wjg.120681
- Dergi Adı: World Journal of Gastroenterology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Age at onset, Biological therapy, Crohn disease, Inflammatory bowel disease, Ulcerative colitis
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
BACKGROUND Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), presents varying clinical characteristics depending on the age at disease onset. With the aging global population, understanding the differences in the presentation and management of older-onset and younger-onset IBD has become increasingly important for optimizing patient care. AIM To evaluate the demographic characteristics of and treatment strategies for older and younger adult patients with IBD. METHODS A retrospective cohort analysis was conducted on adult patients diagnosed with IBD between June 1993 and February 2023. Demographic, clinical, and therapeutic data were compared between patients with an older onset (≥ 60 years) and younger onset (18-60 years) of UC and CD. RESULTS A total of 1245 patients were included, of whom 56 (4.5%) had older-onset disease and 1189 (95.5%) had younger-onset disease. The median follow-up duration was 11 years. UC was more prevalent in the older-onset group (69.6% vs 48.7%, P = 0.002). Biological therapy was used less frequently in older-onset patients (26.8% vs 49.3%, P = 0.001). No significant differences in the extent of UC, CD location or behavior, or perianal involvement were detected between the groups. Smoking and a family history of IBD were more common among patients with a younger age at onset. Extraintestinal manifestations (EIMs) were less frequent in patients with an older age at onset (32.1% vs 51%, P = 0.006). Baseline disease activity scores were similar between groups. Thiopurine use was higher in younger patients (32.9% vs 16.1%, P = 0.008). CONCLUSION IBD patients with an older age at onset exhibit distinct demographic and therapeutic characteristics, particularly a lower frequency of EIMs and decreased utilization of immunosuppressive and biological therapies. This conservative approach likely reflects clinical precautions against treatment-related adverse events in elderly individuals; however, it highlights an urgent clinical need for age-specific guidelines to ensure that these patients receive adequate and safe disease management without compromising long-term outcomes.