Better Outcomes Seen With Late-Onset Ulcerative Colitis
Steroid-free remission more likely in those with late-onset than early-onset disease
FRIDAY, Aug. 20 (HealthDay News) -- Patients with late-onset ulcerative colitis may respond better to therapy in the year after diagnosis than patients with onset of the disease in early adulthood, though they have similar initial presentations, according to research published in the August issue of Clinical Gastroenterology and Hepatology.
Christina Y. Ha, M.D., of Washington University in St. Louis, and colleagues analyzed data from 295 patients with ulcerative colitis. Those newly diagnosed with the condition between the ages of 18 and 30 were defined as "early onset," and those diagnosed at 50 or later were defined as "late onset."
The researchers found that the groups had similar disease extent and severity of symptoms at diagnosis. A year after the diagnosis, those in the late-onset group were more likely to have steroid-free clinical remission (64 versus 49 percent). Of those who needed systemic steroid therapy, the late-onset patients were also more likely to have steroid-free remission by one year (50 versus 32 percent). Former smoking status was a more common risk factor among those in the late-onset group, though positive family history was more common in the early-onset group.
"Treatment of the older ulcerative colitis patient often is challenged by concomitant medication use and comorbid conditions that may affect gastroenterologists' choice of initial induction and maintenance therapies. Given that older patients are at increased risk for steroid-related complications, this work underscores the importance of early initiation of maintenance therapy with mesalamines and consideration of immunomodulator therapy," the authors write.