Comparable safety profiles of biological therapies in elderly patients with IBD

A systematic review comparing the safety profiles of biological therapies in elderly patients with inflammatory bowel disease (IBD) did not reveal significant differences in the rate of adverse events (AEs) between the different treatments. However, infusion/injection reactions occurred more often in patients treated with anti-TNFs. The authors concluded that larger studies are needed to establish sequencing recommendations of biological therapies in this population.

Dr Gustavo Drügg Hahn (McGill University Health Center, Canada) and colleagues conducted a systematic review and meta-analysis to study the safety profiles of biological therapies in elderly patients with IBD [1]. In total, 17 studies assessing the safety profiles of anti-TNFs, vedolizumab, and ustekinumab in participants with IBD aged 60 years or older were included in the systematic review.

No significant difference was detected in the rate of AEs for participants treated with anti-TNFs, vedolizumab, or ustekinumab (mean rate 11.3/100 patient-years; P=0.11). In addition, the infection rate associated with the use of these therapies was comparable (mean rate 9.5/100 patient-years; P=0.56). Participants on anti-TNFs displayed significantly more infusion/injection-related AEs than participants treated with vedolizumab or ustekinumab (P=0.02). In addition, participants treated with vedolizumab/ustekinumab demonstrated higher malignancy rates (P=0.01), though this might be caused by a selection bias of the physician to be more likely to start vedolizumab or ustekinumab in patients with a high risk for malignancy based on the beneficial safety profiles of the new biologicals reported in the clinical trials. The systematic review included 2 studies that directly compared the safety and efficacy of anti-TNFs and vedolizumab, showing similar efficacy and safety of these agents in elderly participants with IBD [2,3].

1. Drügg Hahn G, et al. Safety of Biological Therapies in Elderly IDB: a Systematic Review and Meta-analysis. P318, ECCO 2022, 16–19 February.
2. Adar T, et al. Aliment Pharmacol Ther. 2019;49(7):873–879.
3. Pable BS, et al. Dig Dis Sci. 2021 Jul 15. Doi: 10.1007/s10620-021-07129-5.

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Posted on 12 April 20228 April 2024