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. 2022 Jul 14;16(6):946-953.
doi: 10.1093/ecco-jcc/jjab213.

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

Margalida Calafat  1   2 , Míriam Mañosa  1   2 , Elena Ricart  2   3 , Pilar Nos  2   4 , Eva Iglesias-Flores  5 , Isabel Vera  6 , Antonio López-Sanromán  7 , Jordi Guardiola  8 , Carlos Taxonera  9 , Miguel Mínguez  10 , M Dolores Martín-Arranz  11 , Luisa de Castro  12 , Ruth de Francisco  13 , Montserrat Rivero  14 , Esther Garcia-Planella  15 , Xavier Calvet  2   16 , Santiago García-López  17 , Lucía Márquez  18 , Fernando Gomollón  2   19 , Jesús Barrio  20 , Maria Esteve  2   21 , Fernándo Muñoz  22 , Javier P Gisbert  2   23 , Ana Gutiérrez  2   24 , Joaquín Hinojosa  25 , Federico Argüelles-Arias  26 , David Busquets  27 , Luís Bujanda  2   28 , José L Pérez-Calle  29 , Beatriz Sicilia  30 , Olga Merino  31 , Pilar Martínez  32 , Fernando Bermejo  33 , Rufo Lorente  34 , Manuel Barreiro-de Acosta  35 , Cristina Rodríguez  36 , Mariana Fe García-Sepulcre  37 , David Monfort  38 , Fiorella Cañete  1   2 , Eugeni Domènech  1   2 ; ENEIDA Study Group of GETECCU
Collaborators, Affiliations

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

Margalida Calafat et al. J Crohns Colitis. .

Abstract

Background and aims: Immunomediated adverse events [IAEs] are the most frequently reported infliximab [IFX]-related adverse events. Combination therapy may reduce their incidence, although this strategy is not recommended in elderly patients. We aimed to compare the rates of IFX-related IAEs and loss of response [LOR] in elderly and younger patients.

Methods: Adult patients in the ENEIDA registry who had received a first course of IFX therapy were identified and grouped into two cohorts regarding age at the beginning of treatment [over 60 years and between 18 and 50 years]. The rates of IAEs and LOR were compared.

Results: In total, 939 patients [12%] who started IFX over 60 years of age and 6844 [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 IAEs [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 the two groups [20.5% vs 19.3%; p = 0.438]. In the logistic regression analysis, IFX monotherapy, extraintestinal manifestations and female gender were the only risk factors for IAEs, whereas IFX monotherapy, extraintestinal manifestations and Crohn's disease were risk factors for LOR.

Conclusions: Elderly patients with inflammatory bowel disease have a similar risk of developing IFX-related IAEs and LOR to that of younger patients.

Keywords: Elderly; adverse events; inflammatory bowel disease.

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