Study Shows Treatment of IBD Differs in Older vs. Younger Patients

Understanding medication utilization patterns is important for future evaluations of clinical outcomes, investigators say.

New data from the ongoing TARGET-IBD study found that older patients (>65 years) are significantly more likely to receive aminosalicylate monotherapy as a treatment for both Crohn’s disease and ulcerative colitis compared with younger patients.

“Understanding patterns between these two populations of Crohn’s disease and ulcerative colitis patients is critical to informing future evaluations and clinical outcomes,” Edward Barnes, M.D., assistant professor of medicine, division of Gastroenterology and Hepatology, at the University of North Carolina at Chapel Hill, and lead author of the study, said in a statement. "Given the aging population in the United States and the host of issues that come along with treating older patients, utilization patterns have long-term implications for control of inflammatory bowel disease (IBD)."

Investigators identified 2,980 patients with IBD (61% with Crohn’s disease) across 34 academic or community sites in the United States between July 1, 2017, and February 18, 2020. In patients with Crohn’s disease, younger patients were less likely to use aminosalicylate monotherapy when compared with patients above 65. Younger patients with Crohn’s disease and ulcerative colitis were significantly more likely to use anti–tumor necrosis factor monotherapy than patients above 65 years.

TARGET-IBD is an active five-year longitudinal, observational study of more than 4,400 adult and pediatric patients with IBD receiving care from 36 academic and community centers throughout the United States. Real-world data is collected retrospectively for three years from the time of the patient’s date of consent and patients are also followed prospectively for a minimum of five years. The study is being conducted by Target RWE, a real-world evidence solutions company for the health care industry.

About 1.6 million Americans live with an IBD diagnosis, according to recent estimates. Although the overall incidence of IBD is relatively stable, the prevalence of IBD continues to increase as the population ages. Older adults face practical concerns with IBD treatment.

Another analysis of real-world practice suggests patients are often overtreated with corticosteroids and undertreated with immunomodulators and biologics because of concerns about infections. This study suggests that the management of IBD in older patients needs to be personalized.