Risk of immunomediated adverse events and loss of response to infliximab in elderly patients with inflammatory bowel disease. A cohort study of the ENEIDA registry.

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Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Calafat M
  • Mañosa M
  • Ricart E
  • Iglesias-Flores E
  • Vera I
  • López-SanRomán A
  • Guardiola J
  • Taxonera C
  • Mínguez M
  • Martín-Arranz MD
  • de Castro L
  • de Francisco R
  • Rivero M
  • Garcia-Planella E
  • Calvet X
  • García-López S
  • Márquez L
  • Gomollón F
  • Barrio J
  • Esteve M
  • Muñoz F
  • Gisbert JP
  • Gutiérrez A
  • Hinojosa J
  • Argüelles-Arias F
  • Busquets D
  • Bujanda L
  • Pérez-Calle JL
  • Sicilia B
  • Merino O
  • Martínez P
  • Bermejo F
  • Lorente R
  • Barreiro-de Acosta M
  • Rodríguez C
  • García-Sepulcre MF
  • Monfort D
  • Cañete F
  • Domènech E
  • ENEIDA Study Group of GETECCU

Grupos

Abstract

BACKGROUND: Immunomediated adverse events (IAEs) are the most frequently reported infliximab-related adverse events. Combination therapy may reduce their incidence, although this strategy is not recommended in elderly patients. AIMS: To compare the rates of infliximab-related IAE and loss of response (LOR) in elderly and younger patients. METHODS: Adult patients in the ENEIDA registry who had received a first course of infliximab therapy were identified and grouped into two cohorts regarding age at the beginning of treatment (over 60 and between 18-50 years). The rates of IAEs and LOR were compared. RESULTS: Nine hundred thirty-nine patients (12%) who started infliximab over 60 years of age and 6,844 (88%) below 50 years of age were included. Elderly patients presented a higher proportion of AEs related to IFX (23.2% vs. 19%; P=0.002), infections (7.1% vs. 4.3%; P<0.001) and neoplasms (2.2% vs. 0.5%; P<0.001). In contrast, the rates of IAE (14.8% vs. 14.8%, P=0.999), infusion reactions (8.1% vs. 8.1%, P=0.989), late hypersensitivity (1.3% vs. 1.2%, P=0.895), paradoxical psoriasis (1% vs. 1.5%; P=0.187) and drug-induced lupus erythematosus (0.6% vs. 0.7%; P=0.947) were similar in elderly and younger patients. LOR rates were also similar between both groups (20.5% vs. 19.3%; P=0.438). In the logistic regression analysis, infliximab monotherapy, extraintestinal manifestations and female gender were the only risk factors for IAEs, whereas infliximab monotherapy, extraintestinal manifestations and Crohn's disease were risk factors for LOR. CONCLUSIONS: Elderly patients with IBD have a similar risk of developing infliximab-related IAEs and LOR to that of younger patients.

© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Datos de la publicación

ISSN/ISSNe:
1873-9946, 1876-4479

JOURNAL OF CROHNS & COLITIS  OXFORD UNIV PRESS

Tipo:
Article
Páginas:
946-953
PubMed:
34864947
Factor de Impacto:
2,429 SCImago
Cuartil:
Q1 SCImago

Citas Recibidas en Web of Science: 7

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Keywords

  • Elderly; adverse events; inflammatory bowel disease

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