Thiopurine exposure was 12.8% and 16.4% in elderly-onset UC and CD respectively. In patients with EO-UC, mean time to treatment with thiopurines was 20.7 months, and mean duration of treatment was 29.4 months. In EO-CD, mean time to treatment was 18.2 months, and mean duration of treatment was 33.9 months. No significant differences in time to treatment or duration of treatment were found between elderly-onset UC or CD. Similarly, no significant differences were found in time to treatment or duration of treatment between elderly-onset and adult-onset disease (both UC and CD). Amongst patients with elderly-onset disease receiving thiopurines, there was no difference in the time to thiopurine treatment between patients who had treatment for greater than 12 months duration compared to those with less than 12 months treatment (21.9 months vs 19.4 months in EOUC, p=0.41 and 18.7 months vs 17.6 months in EOCD, p=0.77). Sustained treatment of greater than 12 months in EO-UC was associated with a 70% reduction in risk of colectomy (Table 3). In contrast, sustained thiopurine use was not significantly associated with a reduced risk of first intestinal surgery in EO-CD. Discussion Main findings This is the largest national population-based study of therapies and outcomes in EO-IBD to date, encompassing 20 years. We found approximately 1 in 4 patients with UC and 1 in 5 diagnosed with CD was aged over 60 years at diagnosis. In UC, colectomy rates were similar between elderly and adult-onset disease. In CD, rates of first intestinal surgery were approximately a third lower in the elderly-onset group compared with adult-onset disease. Amongst patients with EO-UC treated with thiopurines, sustained use for longer than 12 months was associated with a 70% reduction in rate of colectomy. By contrast, in EO-CD sustained thiopurine exposure was not associated with a reduced
Thiopurine exposure was 12.8% and 16.4% in elderly-onset UC and CD respectively. In patients with EO-UC, mean time to treatment with thiopurines was 20.7 months, and mean duration of treatment was 29.4 months. In EO-CD, mean time to treatment was 18.2 months, and mean duration of treatment was 33.9 months. No significant differences in time to treatment or duration of treatment were found between elderly-onset UC or CD. Similarly, no significant differences were found in time to treatment or duration of treatment between elderly-onset and adult-onset disease (both UC and CD). Amongst patients with elderly-onset disease receiving thiopurines, there was no difference in the time to thiopurine treatment between patients who had treatment for greater than 12 months duration compared to those with less than 12 months treatment (21.9 months vs 19.4 months in EOUC, p=0.41 and 18.7 months vs 17.6 months in EOCD, p=0.77). Sustained treatment of greater than 12 months in EO-UC was associated with a 70% reduction in risk of colectomy (Table 3). In contrast, sustained thiopurine use was not significantly associated with a reduced risk of first intestinal surgery in EO-CD. Discussion Main findings This is the largest national population-based study of therapies and outcomes in EO-IBD to date, encompassing 20 years. We found approximately 1 in 4 patients with UC and 1 in 5 diagnosed with CD was aged over 60 years at diagnosis. In UC, colectomy rates were similar between elderly and adult-onset disease. In CD, rates of first intestinal surgery were approximately a third lower in the elderly-onset group compared with adult-onset disease. Amongst patients with EO-UC treated with thiopurines, sustained use for longer than 12 months was associated with a 70% reduction in rate of colectomy. By contrast, in EO-CD sustained thiopurine exposure was not associated with a reduced
IBD%20journal%20%2D%20Elderly%20IBD%20paper%20fn.docx