TY - JOUR
T1 - Clinical Characteristics and Treatment Response in Microscopic Colitis Based on Age at Diagnosis
T2 - A Multicenter Retrospective Study
AU - Kamboj, Amrit K.
AU - McGoldrick, Jessica
AU - Voth, Eli
AU - Penrice, Daniel
AU - Tome, June
AU - Gujral, Amandeep
AU - Miller, Kaia
AU - Burke, Kristin E.
AU - Pardi, Darrell S.
AU - Khalili, Hamed
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2022/7
Y1 - 2022/7
N2 - Background: Microscopic colitis (MC) primarily affects older adults; thus, data in younger patients are scarce. Aims: To compare clinical characteristics and treatment response by age at diagnosis. Methods: This retrospective cohort study was performed at Mayo Clinic and Massachusetts General Hospital. Patients were chosen consecutively using established databases. Patients were ‘younger’ if age at diagnosis was ≤ 50 years and ‘older’ if age > 50 years. Treatment outcomes were captured for induction (12 ± 4 weeks), based on the total number of daily stools, and defined as remission (complete resolution), response (≥ 50% improvement), non-response (< 50% improvement), and intolerance. Patients were considered ‘responders’ if they had remission or response and ‘non-responders’ if they had non-response or intolerance. Results: We included 295 patients (52 younger, 243 older). There were no differences in sex, race, MC subtype, and diarrhea severity between groups (all P > 0.05). Younger patients were more likely to have celiac disease (17.3% vs. 5.8%, P = 0.01), while older patients had higher BMI (mean 25.0 vs. 23.8 kg/m2, P = 0.04) were more likely smokers (53.9% vs. 34.6%, P = 0.01) and use NSAIDs (48.6% vs. 15.4%, P < 0.01) and statins (22.6% vs. 3.8%, P < 0.01). Overall treatment response was highest for budesonide (88.3%) and did not differ when comparing older to younger patients (90.6% vs. 77.8%, P = 0.12) or by MC subtype (LC, 81.5% vs. CC, 92.9%, P = 0.07). Conclusions: There are no significant differences in MC treatment response based on age or disease subtype. These findings support treating patients with MC based on symptom severity rather than age.
AB - Background: Microscopic colitis (MC) primarily affects older adults; thus, data in younger patients are scarce. Aims: To compare clinical characteristics and treatment response by age at diagnosis. Methods: This retrospective cohort study was performed at Mayo Clinic and Massachusetts General Hospital. Patients were chosen consecutively using established databases. Patients were ‘younger’ if age at diagnosis was ≤ 50 years and ‘older’ if age > 50 years. Treatment outcomes were captured for induction (12 ± 4 weeks), based on the total number of daily stools, and defined as remission (complete resolution), response (≥ 50% improvement), non-response (< 50% improvement), and intolerance. Patients were considered ‘responders’ if they had remission or response and ‘non-responders’ if they had non-response or intolerance. Results: We included 295 patients (52 younger, 243 older). There were no differences in sex, race, MC subtype, and diarrhea severity between groups (all P > 0.05). Younger patients were more likely to have celiac disease (17.3% vs. 5.8%, P = 0.01), while older patients had higher BMI (mean 25.0 vs. 23.8 kg/m2, P = 0.04) were more likely smokers (53.9% vs. 34.6%, P = 0.01) and use NSAIDs (48.6% vs. 15.4%, P < 0.01) and statins (22.6% vs. 3.8%, P < 0.01). Overall treatment response was highest for budesonide (88.3%) and did not differ when comparing older to younger patients (90.6% vs. 77.8%, P = 0.12) or by MC subtype (LC, 81.5% vs. CC, 92.9%, P = 0.07). Conclusions: There are no significant differences in MC treatment response based on age or disease subtype. These findings support treating patients with MC based on symptom severity rather than age.
KW - Bismuth subsalicylate
KW - Budesonide
KW - Collagenous colitis
KW - Diarrhea
KW - Loperamide
KW - Lymphocytic colitis
KW - Mesalamine
KW - Microscopic colitis
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U2 - 10.1007/s10620-021-07162-4
DO - 10.1007/s10620-021-07162-4
M3 - Article
C2 - 34283360
AN - SCOPUS:85110856605
SN - 0163-2116
VL - 67
SP - 3108
EP - 3114
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 7
ER -