Skip to main content
Top
Published in: Digestive Diseases and Sciences 11/2010

01-11-2010 | Original Article

Biologic Agent Use Varies Inversely with Age at Diagnosis in Crohn’s Disease

Authors: Linda A. Feagins, Stuart J. Spechler

Published in: Digestive Diseases and Sciences | Issue 11/2010

Login to get access

Abstract

Background

For patients with Crohn’s disease, age at onset is known to influence the clinical course of the illness.

Aims

The aim of this study is to seek an association between age at onset of Crohn’s disease and use of biologic agents for its treatment.

Methods

We reviewed the medical records of 127 veteran patients with Crohn’s disease treated at our hospital, and compared differences in age at disease onset between patients who had received biologics and those who had not.

Results

The mean age of our patients was 54.9 ± 15.4 years, and 34% were currently receiving or had previously received treatment with a biologic agent. For those with biologic use, average age at time of diagnosis of Crohn’s disease was 32.3 ± 12.2 years, compared with 43.7 ± 16.3 years for those who had not received biologics (P = 0.005). This relationship remained significant even after controlling for disease severity. The frequency of use of biologic agents varied inversely with age at diagnosis. For patients diagnosed before age 21 years, 55.5% had used biologics, whereas no patient >70 years of age at time of diagnosis had used biologics. We found no significant correlation between biologic use and duration of disease, smoking or ethnicity. Perianal disease and concomitant arthritis were both significantly associated with use of biologics.

Conclusions

In our veteran patients with Crohn’s disease, frequency of treatment with a biologic agent varied inversely with age at disease onset.
Literature
1.
go back to reference Jess T, Riis L, Vind I, et al. Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark. Inflamm Bowel Dis. 2007;13(4):481–489.CrossRefPubMed Jess T, Riis L, Vind I, et al. Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark. Inflamm Bowel Dis. 2007;13(4):481–489.CrossRefPubMed
2.
go back to reference Loftus EV Jr, Silverstein MD, Sandborn WJ, et al. Crohn’s disease in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival. Gastroenterology. 1998;114(6):1161–1168.CrossRefPubMed Loftus EV Jr, Silverstein MD, Sandborn WJ, et al. Crohn’s disease in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival. Gastroenterology. 1998;114(6):1161–1168.CrossRefPubMed
3.
go back to reference Polito JM 2nd, Childs B, Mellits ED, et al. Crohn’s disease: influence of age at diagnosis on site and clinical type of disease. Gastroenterology. 1996;111:580–586.CrossRefPubMed Polito JM 2nd, Childs B, Mellits ED, et al. Crohn’s disease: influence of age at diagnosis on site and clinical type of disease. Gastroenterology. 1996;111:580–586.CrossRefPubMed
4.
go back to reference Andres PG, Friedman LS. Epidemiology and the natural course of inflammatory bowel disease. Gastroenterol Clin North Am. 1999;28(2):255–281. vii.CrossRefPubMed Andres PG, Friedman LS. Epidemiology and the natural course of inflammatory bowel disease. Gastroenterol Clin North Am. 1999;28(2):255–281. vii.CrossRefPubMed
5.
go back to reference Carr N, Schofield PF. Inflammatory bowel disease in the older patient. Br J Surg. 1982;69:223–225.CrossRefPubMed Carr N, Schofield PF. Inflammatory bowel disease in the older patient. Br J Surg. 1982;69:223–225.CrossRefPubMed
6.
go back to reference Beaugerie L, Seksik P, Nion-Larmurier I, et al. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–656.CrossRefPubMed Beaugerie L, Seksik P, Nion-Larmurier I, et al. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–656.CrossRefPubMed
7.
go back to reference Thia KT, Luman W, Jin OC. Crohn’s disease runs a more aggressive course in young Asian patients. Inflamm Bowel Dis. 2006;12(1):57–61.CrossRefPubMed Thia KT, Luman W, Jin OC. Crohn’s disease runs a more aggressive course in young Asian patients. Inflamm Bowel Dis. 2006;12(1):57–61.CrossRefPubMed
8.
go back to reference Loly C, Belaiche J, Louis E. Predictors of severe Crohn’s disease. Scand J Gastro. 2008;43:948–954.CrossRef Loly C, Belaiche J, Louis E. Predictors of severe Crohn’s disease. Scand J Gastro. 2008;43:948–954.CrossRef
9.
go back to reference Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s disease in adults. Am J Gastroenterol. 2009;104:465–483.CrossRefPubMed Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s disease in adults. Am J Gastroenterol. 2009;104:465–483.CrossRefPubMed
10.
go back to reference Gasche C, Scholmerich J, Brynskov J, et al. A simple classification of Crohn’s disease: report of the working party for the world congress of gastroenterology, Vienna 1998. Inflamm Bowel Dis. 2000;6:8–15.CrossRefPubMed Gasche C, Scholmerich J, Brynskov J, et al. A simple classification of Crohn’s disease: report of the working party for the world congress of gastroenterology, Vienna 1998. Inflamm Bowel Dis. 2000;6:8–15.CrossRefPubMed
Metadata
Title
Biologic Agent Use Varies Inversely with Age at Diagnosis in Crohn’s Disease
Authors
Linda A. Feagins
Stuart J. Spechler
Publication date
01-11-2010
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 11/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-010-1397-9

Other articles of this Issue 11/2010

Digestive Diseases and Sciences 11/2010 Go to the issue