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Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study
BACKGROUND: Life expectancy in people with inflammatory bowel disease (IBD) has increased but remains shorter than in people without IBD. We describe the life expectancy associated with IBD therapies among the growing number of older adults living with IBD. METHODS: Older adults (≥ 65 years) with IB...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728958/ https://www.ncbi.nlm.nih.gov/pubmed/34983400 http://dx.doi.org/10.1186/s12876-021-02083-y |
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author | Kuenzig, M. Ellen Manuel, Douglas G. Donelle, Jessy Benchimol, Eric I. |
author_facet | Kuenzig, M. Ellen Manuel, Douglas G. Donelle, Jessy Benchimol, Eric I. |
author_sort | Kuenzig, M. Ellen |
collection | PubMed |
description | BACKGROUND: Life expectancy in people with inflammatory bowel disease (IBD) has increased but remains shorter than in people without IBD. We describe the life expectancy associated with IBD therapies among the growing number of older adults living with IBD. METHODS: Older adults (≥ 65 years) with IBD were identified from population-based health administrative data using a validated algorithm. Life expectancy on patients’ 65th birthday, stratified by sex, was calculated using a period life table approach from age- and sex-specific mortality rates among patients receiving immunomodulator monotherapy, biologic monotherapy, combination therapy, mesalamine, systemic steroids, and no therapy. RESULTS: Among 28,260 older adults with IBD (239,125 person-years of follow-up), life expectancy at 65 years was longest for patients taking mesalamine (females: 22.1 years, 95% CI 21.8–22.5; males: 19.6 years, 95% CI 19.3–20.0) and shortest for patients taking steroids (females: 11.7 years, 95% CI 11.0–12.4; males 10.3 years, 95% CI 9.7–10.8). Life expectancy was similar for patients receiving immunomodulator monotherapy and biologic monotherapy. Immunomodulator monotherapy was associated with a reduction in life expectancy compared to combination therapy by 5.1 (95% CI 2.3–7.8) in females and 2.8 years (95% CI 0.1–5.5) in males. CONCLUSIONS: Life expectancy varies across therapies used for IBD, with differences likely arising from a combination of medication effectiveness, safety profiles, disease severity, and comorbid conditions. These considerations should be balanced when deciding on a therapeutic approach for the management of IBD in older adults. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-02083-y. |
format | Online Article Text |
id | pubmed-8728958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87289582022-01-06 Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study Kuenzig, M. Ellen Manuel, Douglas G. Donelle, Jessy Benchimol, Eric I. BMC Gastroenterol Research BACKGROUND: Life expectancy in people with inflammatory bowel disease (IBD) has increased but remains shorter than in people without IBD. We describe the life expectancy associated with IBD therapies among the growing number of older adults living with IBD. METHODS: Older adults (≥ 65 years) with IBD were identified from population-based health administrative data using a validated algorithm. Life expectancy on patients’ 65th birthday, stratified by sex, was calculated using a period life table approach from age- and sex-specific mortality rates among patients receiving immunomodulator monotherapy, biologic monotherapy, combination therapy, mesalamine, systemic steroids, and no therapy. RESULTS: Among 28,260 older adults with IBD (239,125 person-years of follow-up), life expectancy at 65 years was longest for patients taking mesalamine (females: 22.1 years, 95% CI 21.8–22.5; males: 19.6 years, 95% CI 19.3–20.0) and shortest for patients taking steroids (females: 11.7 years, 95% CI 11.0–12.4; males 10.3 years, 95% CI 9.7–10.8). Life expectancy was similar for patients receiving immunomodulator monotherapy and biologic monotherapy. Immunomodulator monotherapy was associated with a reduction in life expectancy compared to combination therapy by 5.1 (95% CI 2.3–7.8) in females and 2.8 years (95% CI 0.1–5.5) in males. CONCLUSIONS: Life expectancy varies across therapies used for IBD, with differences likely arising from a combination of medication effectiveness, safety profiles, disease severity, and comorbid conditions. These considerations should be balanced when deciding on a therapeutic approach for the management of IBD in older adults. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-021-02083-y. BioMed Central 2022-01-04 /pmc/articles/PMC8728958/ /pubmed/34983400 http://dx.doi.org/10.1186/s12876-021-02083-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kuenzig, M. Ellen Manuel, Douglas G. Donelle, Jessy Benchimol, Eric I. Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title | Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title_full | Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title_fullStr | Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title_full_unstemmed | Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title_short | Real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
title_sort | real world evidence of the association between medication and life expectancy in elderly inflammatory bowel disease: a population-based cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728958/ https://www.ncbi.nlm.nih.gov/pubmed/34983400 http://dx.doi.org/10.1186/s12876-021-02083-y |
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