{"title":"老年 IBD 流行病学:一项基于全国人口的队列研究。","authors":"Siddharth Singh, Gry Juul Poulsen, Tania Hviid Bisgaard, Linéa Bonfils, Tine Jess","doi":"10.1016/j.cgh.2024.08.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>We examined the incidence and natural history of patients with very elderly-onset (herein, referred to as very late-onset) inflammatory bowel diseases (IBD) (age ≥70y at diagnosis), compared with patients diagnosed between ages 60-69y in Denmark.</p><p><strong>Methods: </strong>In the Danish National Patient Register, between 1980-2018, we identified all individuals ≥60y with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) and examined trends in incidence, cumulative risk of hospitalization, treatment patterns, IBD-related surgery, serious infection, cancer and cardiovascular and venous thromboembolic risks among very late-onset (70-79y or 80+ years) vs. late-onset (60-69y) IBD, using non-parametric competing risk analysis treating death as competing risk.</p><p><strong>Results: </strong>We identified 3,459 patients with onset of CD at age ≥60y (47% ≥70y) and 10,774 patients with onset of UC aged ≥60y (51% ≥70y). Over the last three decades, incidence changes for very late-onset and late-onset IBD have followed the same patterns. Also, both for CD and UC, cumulative incidence of IBD-related hospitalization and corticosteroid use was comparable in very late-onset vs. late-onset patients. However, the burden of disease-modifying therapy, either immunomodulator or TNF antagonist use, and major IBD-related surgery was significantly lower in patients with very late-onset than in late-onset IBD. On the other hand, 5-year risk of serious infections and cardiovascular events was higher in patients with very late-onset IBD.</p><p><strong>Conclusion: </strong>This nationwide cohort study shows that patients diagnosed with very late-onset (≥70y) IBD have a higher relative burden of disease- and aging-related complications, with limited use of steroid-sparing strategies and surgery, compared with late-onset IBD.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":11.6000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epidemiology of Elderly-Onset IBD: A Nationwide Population-based Cohort Study.\",\"authors\":\"Siddharth Singh, Gry Juul Poulsen, Tania Hviid Bisgaard, Linéa Bonfils, Tine Jess\",\"doi\":\"10.1016/j.cgh.2024.08.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>We examined the incidence and natural history of patients with very elderly-onset (herein, referred to as very late-onset) inflammatory bowel diseases (IBD) (age ≥70y at diagnosis), compared with patients diagnosed between ages 60-69y in Denmark.</p><p><strong>Methods: </strong>In the Danish National Patient Register, between 1980-2018, we identified all individuals ≥60y with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) and examined trends in incidence, cumulative risk of hospitalization, treatment patterns, IBD-related surgery, serious infection, cancer and cardiovascular and venous thromboembolic risks among very late-onset (70-79y or 80+ years) vs. late-onset (60-69y) IBD, using non-parametric competing risk analysis treating death as competing risk.</p><p><strong>Results: </strong>We identified 3,459 patients with onset of CD at age ≥60y (47% ≥70y) and 10,774 patients with onset of UC aged ≥60y (51% ≥70y). Over the last three decades, incidence changes for very late-onset and late-onset IBD have followed the same patterns. Also, both for CD and UC, cumulative incidence of IBD-related hospitalization and corticosteroid use was comparable in very late-onset vs. late-onset patients. However, the burden of disease-modifying therapy, either immunomodulator or TNF antagonist use, and major IBD-related surgery was significantly lower in patients with very late-onset than in late-onset IBD. On the other hand, 5-year risk of serious infections and cardiovascular events was higher in patients with very late-onset IBD.</p><p><strong>Conclusion: </strong>This nationwide cohort study shows that patients diagnosed with very late-onset (≥70y) IBD have a higher relative burden of disease- and aging-related complications, with limited use of steroid-sparing strategies and surgery, compared with late-onset IBD.</p>\",\"PeriodicalId\":10347,\"journal\":{\"name\":\"Clinical Gastroenterology and Hepatology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":11.6000,\"publicationDate\":\"2024-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cgh.2024.08.011\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cgh.2024.08.011","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Epidemiology of Elderly-Onset IBD: A Nationwide Population-based Cohort Study.
Background and aims: We examined the incidence and natural history of patients with very elderly-onset (herein, referred to as very late-onset) inflammatory bowel diseases (IBD) (age ≥70y at diagnosis), compared with patients diagnosed between ages 60-69y in Denmark.
Methods: In the Danish National Patient Register, between 1980-2018, we identified all individuals ≥60y with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) and examined trends in incidence, cumulative risk of hospitalization, treatment patterns, IBD-related surgery, serious infection, cancer and cardiovascular and venous thromboembolic risks among very late-onset (70-79y or 80+ years) vs. late-onset (60-69y) IBD, using non-parametric competing risk analysis treating death as competing risk.
Results: We identified 3,459 patients with onset of CD at age ≥60y (47% ≥70y) and 10,774 patients with onset of UC aged ≥60y (51% ≥70y). Over the last three decades, incidence changes for very late-onset and late-onset IBD have followed the same patterns. Also, both for CD and UC, cumulative incidence of IBD-related hospitalization and corticosteroid use was comparable in very late-onset vs. late-onset patients. However, the burden of disease-modifying therapy, either immunomodulator or TNF antagonist use, and major IBD-related surgery was significantly lower in patients with very late-onset than in late-onset IBD. On the other hand, 5-year risk of serious infections and cardiovascular events was higher in patients with very late-onset IBD.
Conclusion: This nationwide cohort study shows that patients diagnosed with very late-onset (≥70y) IBD have a higher relative burden of disease- and aging-related complications, with limited use of steroid-sparing strategies and surgery, compared with late-onset IBD.
期刊介绍:
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.