P0708 Advanced Therapies in Elderly Patients with Inflammatory Bowel Disease: A Comparative Retrospective Cohort Study in Taiwan
Bibliographic record
Abstract
Abstract Background Inflammatory bowel disease (IBD) primarily affects young people, but increasing evidence indicates a shift toward older age. Elderly-onset IBD has several unique features, including atypical presentations and a higher risk for infections and malignancies. However, no studies have compared the clinical outcomes and analyzed the persistence of different advanced therapies in elderly-onset IBD patients. This study aims to address this gap. Methods In this retrospective cohort study, we included all IBD patients receiving advanced therapies and regular follow-ups at the Chang Gung IBD Center from October 2017 and September 2023. Patients were divided into two groups: the elderly-onset group (diagnosed with IBD at age 60 or older) and the control group (diagnosed with IBD before age 60). We compared one- year drug persistence, opportunistic infections, IBD-related admissions, complications, surgeries, and the number of acute flare-ups between the two groups. Additionally, we compared the one-year persistence of different advanced therapies within the elderly-onset group. Results We enrolled 511 IBD patients, with 107 in the elderly-onset group and the remaining in the control group. The elderly-onset group had higher body mass index, more cases of ulcerative colitis, fewer smokers, lower white blood cell count, lower hemoglobin, lower albumin, and a lower proportion of Montreal L3, B2, but a higher proportion of Montreal E1 and E3 diseases, and more Vedolizumab users compared to the control group. In terms of clinical outcomes, both groups had similar steroid-free remission rates, one-year persistence of advanced therapies, opportunistic infections, IBD-related complications, surgeries, and flare-ups. In the elderly group, Infliximab and Ustekinumab showed higher one-year persistence in Crohn’s disease (CD), but there was no statistically significant difference in ulcerative colitis (UC) according to the Kaplan-Meier analysis. There were three independent predictors for one-year advanced therapies persistence, included Montreal L1 (OR:6.722; 95% CI: 1.296-34.852; P=0.023) , Ustekinumab user (OR: 5.672; 95% CI: 1.138-28.267; P=0.034) and hemoglobin (OR: 1.612; 95% CI: 1.210-2.147; P=0.001) with an optimal cutoff value of 11.65 g/dL. Conclusion Elderly-onset IBD patients have unique clinical characteristics. Different advanced therapies persist in elderly-onset CD, but not in UC. References 1.Sturm A, Maaser C, Mendall M, et al. European Crohn’s and Colitis Organisation topical review on IBD in the elderly. J Crohns Colitis. 2017;11:263-273. 2.Sousaa P, Bertanib L, Rodrigues C. Management of inflammatory bowel disease in the elderly: A review. Dig Liver Dis. 2023;55(8):1001-1009.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".