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Older Patients with Crohn’s Disease Benefit from New Medications

Combining medications that suppress the immune system has been successful in treating young patients with Crohn’s disease, but some physicians have been reluctant to use this strategy in older patients because of concerns about safety. Now an Alimentary Pharmacology & Therapeutics study indicates that older patients can be safely and effectively treated with such combined immunosuppression as well.

Wednesday, March 20, 2019 12:01 am EDT
"It is important to treat aggressive Crohn's disease appropriately regardless of age"

Combining medications that suppress the immune system has been successful in treating young patients with Crohn’s disease, but some physicians have been reluctant to use this strategy in older patients because of concerns about safety. Now an Alimentary Pharmacology & Therapeutics study indicates that older patients can be safely and effectively treated with such combined immunosuppression as well.

Among the 1,981 patients in the study, 311 were aged 60 years or older (173 randomised to early combined immunosuppression and 138 to conventional management). Over 24 months, 10 percent of older patients developed Crohn's disease‐related complications (6.4 percent of those in the combined immunosuppression group versus 14.5 percent of those in the conventional management group) and 14 patients died (3.5 percent versus 5.8 percent).

Among the patients who received combined immunosuppression in the study, older patients experienced remission of their disease to a similar extent as those aged under 60 years. There was also no increase in side effects from these medicines in older patients.

“It is important to treat aggressive Crohn's disease appropriately regardless of age,” said lead author Dr. Siddharth Singh, of the University of California San Diego. “This may include early step-up combination therapy of tumour necrosis factor-alpha antagonists with thiopurines, which is effective and safe even in older patients, rather than treating these patients with chronic or repeated courses of corticosteroids.”

Additional Information

Link to Study: https://onlinelibrary.wiley.com/doi/full/10.1111/apt.15214 

About Journal 

Alimentary Pharmacology & Therapeutics is an international journal of gastroenterology and hepatology.

The journal accepts systematic reviews, meta-analyses, randomised controlled trials and original papers concerned with Gastroenterology and Hepatology.

AP&T is particularly interested in therapies and diagnostics, including all aspects of translation from bench to bedside: identification of novel therapeutic targets, epidemiology, clinical trials, drug safety and meta-analyses.

About Wiley

Wiley is a global leader in research and education. Our online scientific, technical, medical, and scholarly journals, and our digital learning, assessment, certification and student-lifecycle services and solutions help universities, academic societies, businesses, governments and individuals to achieve their academic and professional goals. For more than 200 years, we have delivered consistent performance to our stakeholders. The Company's website can be accessed at www.wiley.com.

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