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P280. Characteristics and clinical course of IBD in elderly: report from the web-based IG-IBD Registry

A. Redaelli1, A. Settesoldi2, R. Caccaro3, M. Rea4, A. Orlando5, D. Valpiani6, G. Riegler4, R. Pica7, R. Montanari8, V. Annese2, 1Gastronterology, Monza, Italy, 2University Hospital Careggi, Medical and Surgical Sciences, Florence, Italy, 3Gastroenterology, Padua, Italy, 4Gastroenterology, Naples, Italy, 5Gastroenterology, Palermo, Italy, 6Gastroenterology, Forlì, Italy, 7Gastroenterology, Rome, Italy, 8Gastroenterology, Negrer-Verona, Italy

Background

Information on clinical course of Crohn's disease (CD) and ulcerative colitis (UC) with diagnosis in elderly are scanty.

Methods

We sought to evaluate the clinical characteristic of CD and UC patients older than 65 years at diagnosis included in the web-based platform set up by the Italian Group for IBD (IG-IBD).

Results

A total number of 136 patients were identified. 50 had a diagnosis of CD, 21 male (M:F 0.7), with a mean (±SD) age of 76.7±11 yrs, symptoms onset at 68±7 yrs, diagnosis at 70±5 yrs, disease duration of 6±8 yrs. According to Montreal's classification the localization was 44%, 36%, 29%, and 0% for L1, L2, L3, and L4, respectively. The disease behavior was 64%, 18%, 18%, and 6% for B1, B2, B3, and p, respectively. Therapy administered along follow-up was 80%, 66%, 20%, and 4% for mesalazine, steroids, immunesuppressors (IMS) and anti-TNF-alpha, respectively. 84 had Ulcerative Colitis (UC), 48 male (M:F 1.3), with a mean age of 76.9±10 yrs, age at symptom onset of 71±7 yrs, age at diagnosis of 72±8 yrs, and disease duration of 5±8 yrs. Extension of disease was 11%, 57%, and 32% for E1, E2, and E3, respectively. Therapy during follow-up was 89%, 50%, 20%, and 3.5% for mesalazine, steroids, IMS, and anti-TNF-alpha, respectively. Only six patients (3 male) were initially diagnosed as IBD-unclassified and finally in four UC diagosis was confirmed. Medical therapy was stopped in eight patients for adverse reactions (1 skin rash under mesalazine, six toxicity by thiourines, 1 piastrinopenia during cyclosporin). At the final follow-up, 38% of CD patients and 3.5% of UC patients needed a surgical resection or colectomy, respectively. Nine surgeries (6/19 in CD and 3/3 in UC) occurred at diagnosis or within the first year.

Conclusion

Diagnosis of CD over 65 years was less frequent than for UC (37% vs 62%, p < 0.001), with a prevalence of female gender. Although no IBD-related mortality was reported, a considerable number of CD patients failed medical therapy.

IG-IBD Investigators/Centers not included in the authorships: P. Dulbecco (Genova), F. Costa (Pisa), A. Lanzini (Brescia), M. Devani (Rho), P. Paoluzi (Roma), C. Papi (Roma), L. Spina (S. Donato Milanese), A. Gasbarrini (Roma), F. Bossa (S. Giovanni R), W. Fries (Messina), S. Saibeni (Milano), F. Pallone (Roma), A. Ferronato (Vicenza), G. Grasso (Varese), A. Kohn (Roma), M. Cappello (Palermo), F. Magnolfi (Arezzo), G. Basilisco (Milano), L. Guidi (Roma), L. Benazzato (Verona), R. Sablich (Pordenone), G. Inserra (Catania), A. Azzarone (Bari).