Table 1.
Summary of the trials assessing the efficacy and safety of anti-tumor necrosis factor agents in the elderly inflammatory bowel disease population
| Studies | Type | Patients, n | Age cutoff | Mean age | % Female | % UC | UC phenotype E1/E2/E3 | CD phenotype B1/B2/B3 | CD location L1/L2/L3/L4 | Mean disease duration | Prior Surgery (%) | Charlson Comorbidity Score | Corticosteroids (%) | 5-ASA (%) | Type of anti-TNF | Combo Therapy (%) | Triple IS (%) | Maligancy risk (%) | Severe infections (%) | Mortality Risk (%) | Reported outcomes | Remission at 3/6/12 months (%) | Surgery within 1 year (%) | Delta % difference anti TNF (younger) | Statistical significance |
| Cottone et al[54], 2011 | Prospective | 95 | 65 | 71 | 42.1 | 38.9 | 48.6 (E1+E2) / 51.4 | NA | 34.5/27.6/37.9 | NA | NA | Over 0 in 83.2% | 94.7 | NA | IFX 82.1%, ADA 17.9% | 23.2 | NA | 2.1 | 11.6 | 10.5 | Clinical | 63.2 (timing not available) | NA | +5.3 | NA |
| Desai et al[52], 2013 | Retrospective | 54 | 60 | 72.7 | 66.7 | 31.5 | NA | NA | NA | 19 | NA | Mean 1.3 | 57.4 | NA | IFX 83.3%, ADA 16.7% | 31.5 | NA | NA | 21.1 | 9.3 | Clinical | NA/61.1/NA (partial or complete) | NA | -22.2 | 0.01 |
| Lobatón et al[51], 2015 | Retrospective | 66 | 65 | 70 | 59 | 45 | 0/37/63 | 40/50/10 | 16/37/44/3 | 6 | 38 | Over 0 in 49% of cases | NA | NA | IFX 96%, ADA 4% | NA | NA | 5 | 15 | 5.00% | Clinical | 68/79/NA | 17 | -21 | 0.001 |
| Adar et al[53], 2019 | Retrospective | 131 | 60 | 68 | 42 | 45 | NA / NA / 54 | 34/34/32 | 21/27/52/0 | 13 | 32 | Mean 4 | 60 | NA | IFX 81%, ADA 17%, GOL 2%, CTZ 1% | 36 | 21 | 3.8 | 20 within 1 year | NA | Clinical | 50/54/58 | 11 | NA | NA |
UC: Ulcerative colitis; E1: Proctitis; E2: Left-sided colitis; E3: Pancolitis; CD: Crohn’s disease; B1: Nonsticturing, nonpenetrating; B2: Stricturing; B3: Penetrating; L1: Terminal ileum; L2: Colon; L3: Ileocolon; L4: Isolated upper disease; 5-ASA: 5-aminosalicylic acid; TNF: Tumor necrosis factor; triple IS: Triple immunosuppression (defined as steroids, an immunomodulatory drug and an anti-TNF agent); IFX: Infliximab; ADA: Adalimumab; GOL: Golimumab; CTZ: Certolizumab; NA: Not available.