AGA Clinical Practice Update on Management of Inflammatory Bowel Disease in Elderly Patients: Expert Review
AGA Clinical Practice Update on Management of Inflammatory Bowel Disease in Elderly Patients: Expert Review - American Gastroenterological Association (AGA)
Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), can present at any age including in elderly patients, commonly defined as 60 years and older. Hence, considering both incident elderly patients with IBD and the aging prevalent IBD population, there will be increasing numbers of elderly patients with IBD. The care of elderly patients with IBD poses unique challenges with respect to diagnosis and therapeutic decision making.
It is becoming apparent that treatment of IBD in elderly patients requires special consideration while accounting for the effectiveness of immunosuppressive therapies in this subpopulation and less favorable safety profiles. In this review, we present best practice advice statements on the diagnosis and management of IBD in elderly patients (Table 1). It should be noted that most clinical data to inform these practices are based on observational data or indirect evidence because elderly patients with IBD comprise a very small proportion of participants enrolled in IBD clinical trials or long-term pharmacovigilance initiatives. This expert review was commissioned and approved by the American Gastroenterological Association (AGA) Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and it underwent internal peer review by the Clinical Practice Updates Committee and external peer review through the standard procedures of the Gastroenterology journal.
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