生物疗法与老年炎症性肠病（IBD）患者感染风险增加相关。然而，关于优特克单抗与抗肿瘤坏死因子（抗TNF）药物在老年人中的安全性和有效性的数据很少。该研究旨在比较优特克单抗和抗TNF药物在老年克罗恩病中的安全性和有效性（CD）患者。开始使用优特克单抗或抗 TNF 药物治疗 CD 的年龄≥60 岁的患者被纳入该回顾性多中心队列。主要结局是需要住院治疗的严重感染的发生率。通过 6 个月时的临床缓解、临床反应和治疗持续率来评估有效性。我们使用治疗权重逆概率 (IPTW) 调整混杂因素，并进行逻辑回归分析，以评估与严重感染、临床缓解和治疗持续性相关的因素。纳入了 83 名开始乌特克单抗治疗的患者和 124 名开始抗 TNF 治疗的患者。倾向调整后，抗 TNF 药物 (2.8%) 和优特克单抗 (3.1%) 之间的严重感染率没有差异 (P = .924)。 6 个月时，优特克单抗 (55.9%) 和抗 TNF 药物 (52.4%) 的临床缓解率相当 (P = 0.762)。 6 个月时，两组的 HBI 均显着降低。 6 个月时，乌特克单抗 (90.6%) 和抗 TNF 药物 (90.0%) 的治疗持续率相当。 Cox 回归分析未显示治疗持续性（风险比，1.23；95% 置信区间，0.57-2.61；P = .594）和严重感染发生率（风险比，1.38；95% 置信区间，0.25-7.57；P）方面存在差异。 = .709) 6 个月。我们观察到乌特克单抗和抗 TNF 药物治疗老年 CD 患者的安全性和有效性相当。© 皇冠版权所有 2024。

Biologic therapies are associated with increased infection risk among elderly patients with inflammatory bowel disease (IBD). However, there are few data on the safety and effectiveness of ustekinumab compared with anti-tumor necrosis factor (anti-TNF) agents in the elderly.The study sought to compare the safety and effectiveness of ustekinumab and anti-TNF agents in elderly Crohn's disease (CD) patients. Patients ≥60 years of age who commenced ustekinumab or an anti-TNF agent for CD were included in this retrospective multicenter cohort. The primary outcome was incidence of serious infections requiring hospitalization. Effectiveness was assessed by clinical remission, clinical response, and treatment persistence rates at 6 months. We adjusted for confounders using inverse probability of treatment weighting (IPTW) and performed a logistic regression analysis to assess factors associated with serious infections, clinical remission, and treatment persistence.Eighty-three patients commencing ustekinumab and 124 commencing anti-TNF therapy were included. There was no difference in serious infection rates between anti-TNF agents (2.8%) and ustekinumab (3.1%) (P = .924) after propensity adjustment. Clinical remission rates were comparable at 6 months for ustekinumab (55.9%) and anti-TNF agents (52.4%) (P = .762). There was a significant reduction in HBI at 6 months in both groups. Treatment persistence was comparable between ustekinumab (90.6%) and anti-TNF agents (90.0%) at 6 months. Cox regression analysis did not show differences in treatment persistence (hazard ratio, 1.23; 95% confidence interval, 0.57-2.61; P = .594) and serious infection incidence (hazard ratio, 1.38; 95% confidence interval, 0.25-7.57; P = .709) by 6 months.We observed comparable safety and effectiveness for ustekinumab and anti-TNF agents in treating elderly CD patients.© Crown copyright 2024.