Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Efficacy and Safety of Biological Therapies and Jak Inhibitors in Older Patients with Inflammatory Bowel Disease

Version 1 : Received: 7 June 2023 / Approved: 8 June 2023 / Online: 8 June 2023 (09:30:13 CEST)

A peer-reviewed article of this Preprint also exists.

Fries, W.; Basile, G.; Bellone, F.; Costantino, G.; Viola, A. Efficacy and Safety of Biological Therapies and JAK Inhibitors in Older Patients with Inflammatory Bowel Disease. Cells 2023, 12, 1722. Fries, W.; Basile, G.; Bellone, F.; Costantino, G.; Viola, A. Efficacy and Safety of Biological Therapies and JAK Inhibitors in Older Patients with Inflammatory Bowel Disease. Cells 2023, 12, 1722.

Abstract

With the introduction of more and more monoclonal antibodies selectively targeting various mediators of the immune-system, together with Janus-Kinase (JAK)-inhibitors with variable affinities towards different JAK subtypes, the available therapeutic options for the treatment of inflammatory bowel diseases (IBD) have undergone an acceleration in the last five years. On the other hand, the prevalence of IBD patients over 65-years of age is steadily increasing and, with this, there is a large population of patients that presents more comorbidities, polypharmacy, and, more frequently, frailty compared to younger patients, exposing them to potentially major risks for adverse events deriving from newer therapies, e.g. infections, cardiovascular risks, and malignancies. Unfortunately, pivotal trials for the commercialization of new therapies rarely include older IBD patients and those with serious comorbidities are virtually excluded. In the present review, we focus on existing literature from pivotal trials and real-world studies, analyzing data on efficacy/effectiveness and safety of newer therapies in older IBD patients with special emphasis on comorbidities and frailty, two distinct but intercorrelated aspects of the older population since age by itself seems to be of minor importance.

Keywords

frailty, comorbidities, Crohn's disease, ulcerative colitis, infections, malignancies

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

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