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Multicenter Study
. 2022 Jul;67(7):3108-3114.
doi: 10.1007/s10620-021-07162-4. Epub 2021 Jul 20.

Clinical Characteristics and Treatment Response in Microscopic Colitis Based on Age at Diagnosis: A Multicenter Retrospective Study

Amrit K Kamboj  1 , Jessica McGoldrick  2 , Eli Voth  3 , Daniel Penrice  3 , June Tome  3 , Amandeep Gujral  2 , Kaia Miller  2 , Kristin E Burke  2   4 , Darrell S Pardi  1 , Hamed Khalili  5   6   7
Affiliations
Multicenter Study

Clinical Characteristics and Treatment Response in Microscopic Colitis Based on Age at Diagnosis: A Multicenter Retrospective Study

Amrit K Kamboj et al. Dig Dis Sci. 2022 Jul.

Abstract

Background: Microscopic colitis (MC) primarily affects older adults; thus, data in younger patients are scarce.

Aims: To compare clinical characteristics and treatment response by age at diagnosis.

Methods: This retrospective cohort study was performed at Mayo Clinic and Massachusetts General Hospital. Patients were chosen consecutively using established databases. Patients were 'younger' if age at diagnosis was ≤ 50 years and 'older' if age > 50 years. Treatment outcomes were captured for induction (12 ± 4 weeks), based on the total number of daily stools, and defined as remission (complete resolution), response (≥ 50% improvement), non-response (< 50% improvement), and intolerance. Patients were considered 'responders' if they had remission or response and 'non-responders' if they had non-response or intolerance.

Results: We included 295 patients (52 younger, 243 older). There were no differences in sex, race, MC subtype, and diarrhea severity between groups (all P > 0.05). Younger patients were more likely to have celiac disease (17.3% vs. 5.8%, P = 0.01), while older patients had higher BMI (mean 25.0 vs. 23.8 kg/m2, P = 0.04) were more likely smokers (53.9% vs. 34.6%, P = 0.01) and use NSAIDs (48.6% vs. 15.4%, P < 0.01) and statins (22.6% vs. 3.8%, P < 0.01). Overall treatment response was highest for budesonide (88.3%) and did not differ when comparing older to younger patients (90.6% vs. 77.8%, P = 0.12) or by MC subtype (LC, 81.5% vs. CC, 92.9%, P = 0.07).

Conclusions: There are no significant differences in MC treatment response based on age or disease subtype. These findings support treating patients with MC based on symptom severity rather than age.

Keywords: Bismuth subsalicylate; Budesonide; Collagenous colitis; Diarrhea; Loperamide; Lymphocytic colitis; Mesalamine; Microscopic colitis.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Fig. 1
Fig. 1
Comparison of response to common MC therapies according to age of diagnosis
Fig. 2
Fig. 2
Comparison of response therapy according to disease subtype
See this image and copyright information in PMC

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