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.

中文翻译：

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与年轻炎症性肠病患者相比，老年患者使用更多的氨基水杨酸单药疗法：TARGET-IBD

目标： 

本研究的目的是描述老年炎症性肠病 (IBD) 患者的药物使用模式。

背景： 

尽管患有克罗恩病 (CD) 和溃疡性结肠炎 (UC) 的老年患者数量不断增加，但与年轻人群相比，药物使用模式仍然存在疑问。

材料和方法： 

我们从多中心观察队列 TARGET-IBD 的 34 个站点收集了数据。本研究的主要结果是与年轻年龄组相比，老年 IBD 患者所使用的 IBD 特异性治疗。使用成对比较分析治疗使用情况，然后使用多变量逻辑回归模型评估 65 岁以上患者使用 IBD 特异性治疗的几率。

结果： 

我们确定了 2980 名 IBD 患者（61% CD）。在多变量分析中，与 65 岁以上的患者相比，年轻的 UC 患者使用氨基水杨酸单药治疗的可能性显着降低 [18 至 29 岁：调整后的比值比 (aOR)=0.51，95% 置信区间 (CI)：0.33-0.78] 。在 CD 患者中，与 65 岁以上患者相比，年轻患者使用氨基水杨酸盐​​单药治疗的可能性显着降低（最大差异年龄 18 至 29 岁：aOR=0.31，95% CI：0.18-0.52）。年轻的 CD 和 UC 患者比 65 岁以上的患者更有可能使用抗肿瘤坏死因子单药治疗（18 至 29 岁：aOR=3.87，95% CI：2.47-6.06 和 aOR=2.68，95% CI：1.29分别为-5.58）。

结论： 

与年轻年龄组相比，老年 IBD患者在药物使用方面表现出显着差异，包括更多的氨基水杨酸单药治疗和更少的抗肿瘤坏死因子单药治疗。鉴于美国人口老龄化，这些利用模式可能对疾病控制产生长期影响。