Hospitalizations less likely among older patients with IBD on Entyvio
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Older patients with inflammatory bowel disease who initiate Entyvio therapy had lower risk for hospitalization than those treated with anti-TNF, according to research presented at the Crohn’s and Colitis Congress.
Bharati Kochar, MD, from Massachusetts General Hospital, said that while older adults make up a large portion of patients with IBD in the United States, they are not well represented in clinical trials.
“While more than a quarter of Americans with IBD are older than 65, less than 1% of adults in clinical trials of approved IBD therapies are 65 years or older,” she said. “Most trials do not publish subgroup analyses of efficacy and safety in older adults. Therefore, we don’t know how well these medications work and how safe they are, specifically, in older adults.”
Researchers analyzed data from a 20% sample of a Medicare claims database covering all 50 states. They included patients who started Entyvio (vedolizumab, Takeda) treatment (n = 488) or anti-TNF therapy (n = 2,213) following 12 months of continuous enrollment in Medicare fee-for-service Parts A/B/D without either study drug. Patients were aged at least 65 years and had at least two international classifications of disease codes for Crohn’s disease or ulcerative colitis.
Investigators compared outcomes, including hospitalizations, IBD-related surgery and new corticosteroid use at least 60 days after drug initiation, between the two groups.
Researchers found that patients who initiated vedolizumab were less likely to be hospitalized in the 12 months after starting treatment (HR = 0.81; 95% CI, 0.68-0.96) compared with those treated with anti-TNF.
There was no difference in IBD-related hospitalizations, IBD-related surgery and steroid use.
“It’s important to use your clinical judgement to treat the patient in front of you,” Kochar said. “These data should simply help contextualize risk for older IBD patients newly initiating vedolizumab and anti-TNF agents.”
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Kochar B, et al. Adult IBD: Quick Shots Abstracts and Case Discussions. Presented at: Crohn’s and Colitis Congress. Jan. 21-24, 2020.
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