Anti-TNF alpha antagonists and Entyvio both appeared equally safe and effective among a population of older patients with inflammatory bowel disease, according to study results published in Alimentary Pharmacology & Therapeutics.
Ashwin N. Ananthakrishnan, MD, MPH, of the division of gastroenterology at Massachusetts General Hospital, and colleagues wrote that finding optimal treatment strategies for older patients with IBD is becoming more important as the population grows.
“With the availability of therapies that differ in their mechanisms of action, studies of comparative effectiveness and safety are important to appropriately position them within the therapeutic algorithm,” they wrote. “This is of great importance in older individuals with IBD, a growing patient subgroup, who are particularly vulnerable not only to the consequences of active disease but also to therapyrelated adverse events, particularly infections from systemic immunosuppression.”
Researchers compared the safety and efficacy of anti-TNF and Entyvio (vedolizumab, Takeda) in a retrospective study of patients with IBD aged at least 60 years. They explored the occurrence of infection or malignancy within one year after therapy, as well as clinical remission at 3, 6 and 12 months.
At one year, investigators found no significant differences in safety profile between the 131 patients taking anti-TNF and 103 patients taking vedolizumab. They observed infections in 20% of the patients on anti-TNF and in 17% of patients on vedolizumab.
Ananthakrishnan and colleagues found that more patients in the anti-TNF group were in remission at 3 months compared with vedolizumab (OR = 2.82, 95% CI, 1.18–6.76). However, the difference was not maintained at 6 or 12 months.
“Both antiTNF and [vedolizumab] therapy are comparably safe and effective in older patients with IBD,” they wrote. “With the growing burden of IBD in older individuals, there is an important need both for prospective studies in elderly IBD patients as well as an effort to include them in clinical trials so that safety and efficacy can be robustly estimated.” – by Alex Young
Disclosures: Anathakrishnan has served on scientific boards for AbbVie, Gilead, Merck and Takeda, and he has received research support from Pfizer. Please see the full study for all other authors’ relevant financial disclosures.