Mild endoscopic disease activity poses risk for older adults with IBD

For older adults with inflammatory bowel disease (IBD), mild endoscopic activity is linked to adverse IBD-specific and morbidity-related outcomes relative to endoscopic remission, as reported in a retrospective study.

The study included 504 adults with IBD ages ≥60 years who had mild or no disease activity on endoscopy. These patients had a median disease duration of 11 years.

The primary outcome was a composite of major IBD-specific adverse events (hospitalizations, surgery, and prescription of corticosteroids for IBD-related symptoms) within 1 year of endoscopic assessment. A composite of 1-year morbidity-related events (mortality, all-cause hospitalization, infection requiring antibiotics, venous thromboembolism, cardiovascular events, and osteoporotic fractures) was assessed as the secondary outcome. Both outcomes were also evaluated at 5 years.

Of the patients, 192 (38.1 percent) had mild endoscopic disease and 312 (61.9 percent) were in endoscopic remission. Multivariable analysis showed that compared with endoscopic remission, mild endoscopic disease activity was associated with fourfold greater odds of a 1-year adverse IBD-specific outcome (adjusted odds ratio [aOR], 4.16, 95 percent confidence interval [CI], 2.10–8.24). This association persisted up to 5 years.

Mild endoscopic disease also showed an association with increased odds of experiencing an adverse morbidity-related outcome within 1 year relative to endoscopic remission (aOR, 1.56, 95 percent CI, 1.01–2.43).

The present data underscore the importance of achieving endoscopic remission, which may provide both short- and longer-term benefits in this population, according to researchers.