Cristina Suárez Ferrer, Francisco Mesonero Gismero, Berta Caballol, Maria Pilar Ballester, Iria Bastón Rey, Andrés Castaño García, Jose Miranda Bautista, Rosa Saiz Chumillas, Jose Manuel Benitez, Laura Sanchez-Delgado, Alicia López-García, Cristina Rubin de Celix, Inmaculada Alonso Abreu, Luigi Melcarne, Rocío Plaza Santos, Miquel Marques-Camí, Antonio Caballero Mateos, César Gómez Díez, Margalida Calafat, Horacio Alonso Galan, Pablo Vega Vilaamil, Beatriz Castro Senosiain, Andrea Guerro Moya, Carmen Yolanda Rodriguez Diaz, Katerina Spicakova, Noemi Manceñido Marcos, Gema Molina, Luisa de Castro Parga, Andres Rodriguez Angulo, Lidia Cuevas Del Campo, Maria Del Carmen Rodriguez Grau, Fernando Ramirez, Barbara Gomez Pastrana, Irene Gonzalez Partida, Belen Botella Mateu, Elena Peña Gonzalez, Eduardo Iyo, Alfonso Elosua Gonzalez, Empar Sainz Arnau, Luis Hernandez Villalba, Pablo Perez Galindo, Leyanira Torrealba Medina, Sara Monsalve Alonso, Jose Antonio Olmos Perez, Carmen Dueñas Sadornil, Laura Garcia Ramirez, María Dolores Martín-Arranz, Antonio López Sanroman, Agnès Fernández, Victor Merino Murgui, Cristina Calviño Suárez, Pablo Flórez-Diez, María Elena Lobato Matilla, Beatriz Sicilia, Pilar Soto Escribano, Carlos Maroto Martin, Míriam Mañosa, Manuel Barreiro-De Acosta
{"title":"老年炎症性肠病生物治疗的有效性和安全性:GETECCU队列的结果。","authors":"Cristina Suárez Ferrer, Francisco Mesonero Gismero, Berta Caballol, Maria Pilar Ballester, Iria Bastón Rey, Andrés Castaño García, Jose Miranda Bautista, Rosa Saiz Chumillas, Jose Manuel Benitez, Laura Sanchez-Delgado, Alicia López-García, Cristina Rubin de Celix, Inmaculada Alonso Abreu, Luigi Melcarne, Rocío Plaza Santos, Miquel Marques-Camí, Antonio Caballero Mateos, César Gómez Díez, Margalida Calafat, Horacio Alonso Galan, Pablo Vega Vilaamil, Beatriz Castro Senosiain, Andrea Guerro Moya, Carmen Yolanda Rodriguez Diaz, Katerina Spicakova, Noemi Manceñido Marcos, Gema Molina, Luisa de Castro Parga, Andres Rodriguez Angulo, Lidia Cuevas Del Campo, Maria Del Carmen Rodriguez Grau, Fernando Ramirez, Barbara Gomez Pastrana, Irene Gonzalez Partida, Belen Botella Mateu, Elena Peña Gonzalez, Eduardo Iyo, Alfonso Elosua Gonzalez, Empar Sainz Arnau, Luis Hernandez Villalba, Pablo Perez Galindo, Leyanira Torrealba Medina, Sara Monsalve Alonso, Jose Antonio Olmos Perez, Carmen Dueñas Sadornil, Laura Garcia Ramirez, María Dolores Martín-Arranz, Antonio López Sanroman, Agnès Fernández, Victor Merino Murgui, Cristina Calviño Suárez, Pablo Flórez-Diez, María Elena Lobato Matilla, Beatriz Sicilia, Pilar Soto Escribano, Carlos Maroto Martin, Míriam Mañosa, Manuel Barreiro-De Acosta","doi":"10.1016/j.gastrohep.2024.502197","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Biological therapies used for the treatment of inflammatory bowel disease (IBD) have shown to be effective and safe, although these results were obtained from studies involving mostly a young population, who are generally included in clinical trials. The aim of our study was to determine the efficacy and safety of the different biological treatments in the elderly population.</p><p><strong>Methods: </strong>Multicenter study was carried out in the GETECCU group. Patients diagnosed with IBD and aged over 65 years at the time of initiating biological therapy (infliximab, adalimumab, golimumab, ustekinumab or vedolizumab) were retrospectively included. Among the patients included, clinical response was assessed after drug induction (12 weeks of treatment) and at 52 weeks. Patients' colonoscopy data in week 52 were assessment, where available. Regarding complications, development of oncological events during follow-up and infectious processes occurring during biological treatment were collected (excluding bowel infection by cytomegalovirus).</p><p><strong>Results: </strong>A total of 1090 patients were included. After induction, at approximately 12-14 weeks of treatment, 419 patients (39.6%) were in clinical remission, 502 patients (47.4%) had responded without remission and 137 patients (12.9%) had no response. At 52 weeks of treatment 442 patients (57.1%) had achieved clinical remission, 249 patients had responded without remission (32.2%) and 53 patients had no response to the treatment (6.8%). Before 52 weeks, 129 patients (14.8%) had discontinued treatment due to inefficacy, this being significantly higher (p<0.0001) for Golimumab - 9 patients (37.5%) - compared to the other biological treatments analyzed. With respect to tumor development, an oncological event was observed in 74 patients (6.9%): 30 patients (8%) on infliximab, 23 (7.14%) on adalimumab, 3 (11.1%) on golimumab, 10 (6.4%) on ustekinumab, and 8 (3.8%) on vedolizumab. The incidence was significantly lower (p=0.04) for the vedolizumab group compared to other treatments. As regards infections, these occurred in 160 patients during treatment (14.9%), with no differences between the different biologicals used (p=0.61): 61 patients (19.4%) on infliximab, 39 (12.5%) on adalimumab, 5 (17.8%) on golimumab, 22 (14.1%) on ustekinumab, and 34 (16.5%) on vedolizumab.</p><p><strong>Conclusions: </strong>Biological drug therapies have response rates in elderly patients similar to those described in the general population, Golimumab was the drug that was discontinued most frequently due to inefficacy. In our experience, tumor development was more frequent in patients who used anti-TNF therapies compared to other targets, although its incidence was generally low and that this is in line with younger patients based on previous literature.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of biological treatment for inflammatory bowel disease in elderly patients: Results from a GETECCU cohort.\",\"authors\":\"Cristina Suárez Ferrer, Francisco Mesonero Gismero, Berta Caballol, Maria Pilar Ballester, Iria Bastón Rey, Andrés Castaño García, Jose Miranda Bautista, Rosa Saiz Chumillas, Jose Manuel Benitez, Laura Sanchez-Delgado, Alicia López-García, Cristina Rubin de Celix, Inmaculada Alonso Abreu, Luigi Melcarne, Rocío Plaza Santos, Miquel Marques-Camí, Antonio Caballero Mateos, César Gómez Díez, Margalida Calafat, Horacio Alonso Galan, Pablo Vega Vilaamil, Beatriz Castro Senosiain, Andrea Guerro Moya, Carmen Yolanda Rodriguez Diaz, Katerina Spicakova, Noemi Manceñido Marcos, Gema Molina, Luisa de Castro Parga, Andres Rodriguez Angulo, Lidia Cuevas Del Campo, Maria Del Carmen Rodriguez Grau, Fernando Ramirez, Barbara Gomez Pastrana, Irene Gonzalez Partida, Belen Botella Mateu, Elena Peña Gonzalez, Eduardo Iyo, Alfonso Elosua Gonzalez, Empar Sainz Arnau, Luis Hernandez Villalba, Pablo Perez Galindo, Leyanira Torrealba Medina, Sara Monsalve Alonso, Jose Antonio Olmos Perez, Carmen Dueñas Sadornil, Laura Garcia Ramirez, María Dolores Martín-Arranz, Antonio López Sanroman, Agnès Fernández, Victor Merino Murgui, Cristina Calviño Suárez, Pablo Flórez-Diez, María Elena Lobato Matilla, Beatriz Sicilia, Pilar Soto Escribano, Carlos Maroto Martin, Míriam Mañosa, Manuel Barreiro-De Acosta\",\"doi\":\"10.1016/j.gastrohep.2024.502197\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Biological therapies used for the treatment of inflammatory bowel disease (IBD) have shown to be effective and safe, although these results were obtained from studies involving mostly a young population, who are generally included in clinical trials. The aim of our study was to determine the efficacy and safety of the different biological treatments in the elderly population.</p><p><strong>Methods: </strong>Multicenter study was carried out in the GETECCU group. Patients diagnosed with IBD and aged over 65 years at the time of initiating biological therapy (infliximab, adalimumab, golimumab, ustekinumab or vedolizumab) were retrospectively included. Among the patients included, clinical response was assessed after drug induction (12 weeks of treatment) and at 52 weeks. Patients' colonoscopy data in week 52 were assessment, where available. Regarding complications, development of oncological events during follow-up and infectious processes occurring during biological treatment were collected (excluding bowel infection by cytomegalovirus).</p><p><strong>Results: </strong>A total of 1090 patients were included. After induction, at approximately 12-14 weeks of treatment, 419 patients (39.6%) were in clinical remission, 502 patients (47.4%) had responded without remission and 137 patients (12.9%) had no response. At 52 weeks of treatment 442 patients (57.1%) had achieved clinical remission, 249 patients had responded without remission (32.2%) and 53 patients had no response to the treatment (6.8%). Before 52 weeks, 129 patients (14.8%) had discontinued treatment due to inefficacy, this being significantly higher (p<0.0001) for Golimumab - 9 patients (37.5%) - compared to the other biological treatments analyzed. With respect to tumor development, an oncological event was observed in 74 patients (6.9%): 30 patients (8%) on infliximab, 23 (7.14%) on adalimumab, 3 (11.1%) on golimumab, 10 (6.4%) on ustekinumab, and 8 (3.8%) on vedolizumab. The incidence was significantly lower (p=0.04) for the vedolizumab group compared to other treatments. As regards infections, these occurred in 160 patients during treatment (14.9%), with no differences between the different biologicals used (p=0.61): 61 patients (19.4%) on infliximab, 39 (12.5%) on adalimumab, 5 (17.8%) on golimumab, 22 (14.1%) on ustekinumab, and 34 (16.5%) on vedolizumab.</p><p><strong>Conclusions: </strong>Biological drug therapies have response rates in elderly patients similar to those described in the general population, Golimumab was the drug that was discontinued most frequently due to inefficacy. In our experience, tumor development was more frequent in patients who used anti-TNF therapies compared to other targets, although its incidence was generally low and that this is in line with younger patients based on previous literature.</p>\",\"PeriodicalId\":12802,\"journal\":{\"name\":\"Gastroenterologia y hepatologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-05-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterologia y hepatologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.gastrohep.2024.502197\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterologia y hepatologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.gastrohep.2024.502197","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Efficacy and safety of biological treatment for inflammatory bowel disease in elderly patients: Results from a GETECCU cohort.
Introduction: Biological therapies used for the treatment of inflammatory bowel disease (IBD) have shown to be effective and safe, although these results were obtained from studies involving mostly a young population, who are generally included in clinical trials. The aim of our study was to determine the efficacy and safety of the different biological treatments in the elderly population.
Methods: Multicenter study was carried out in the GETECCU group. Patients diagnosed with IBD and aged over 65 years at the time of initiating biological therapy (infliximab, adalimumab, golimumab, ustekinumab or vedolizumab) were retrospectively included. Among the patients included, clinical response was assessed after drug induction (12 weeks of treatment) and at 52 weeks. Patients' colonoscopy data in week 52 were assessment, where available. Regarding complications, development of oncological events during follow-up and infectious processes occurring during biological treatment were collected (excluding bowel infection by cytomegalovirus).
Results: A total of 1090 patients were included. After induction, at approximately 12-14 weeks of treatment, 419 patients (39.6%) were in clinical remission, 502 patients (47.4%) had responded without remission and 137 patients (12.9%) had no response. At 52 weeks of treatment 442 patients (57.1%) had achieved clinical remission, 249 patients had responded without remission (32.2%) and 53 patients had no response to the treatment (6.8%). Before 52 weeks, 129 patients (14.8%) had discontinued treatment due to inefficacy, this being significantly higher (p<0.0001) for Golimumab - 9 patients (37.5%) - compared to the other biological treatments analyzed. With respect to tumor development, an oncological event was observed in 74 patients (6.9%): 30 patients (8%) on infliximab, 23 (7.14%) on adalimumab, 3 (11.1%) on golimumab, 10 (6.4%) on ustekinumab, and 8 (3.8%) on vedolizumab. The incidence was significantly lower (p=0.04) for the vedolizumab group compared to other treatments. As regards infections, these occurred in 160 patients during treatment (14.9%), with no differences between the different biologicals used (p=0.61): 61 patients (19.4%) on infliximab, 39 (12.5%) on adalimumab, 5 (17.8%) on golimumab, 22 (14.1%) on ustekinumab, and 34 (16.5%) on vedolizumab.
Conclusions: Biological drug therapies have response rates in elderly patients similar to those described in the general population, Golimumab was the drug that was discontinued most frequently due to inefficacy. In our experience, tumor development was more frequent in patients who used anti-TNF therapies compared to other targets, although its incidence was generally low and that this is in line with younger patients based on previous literature.
期刊介绍:
Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.