In both elderly and young patients having IBD, vedolizumab  is equally effective. In the elderly patient population, treatment with vedolizumab is linked with a higher risk of infection rates. This might be linked to their age and the underlying disorders.

A binational, multicentre, retrospective, cohort study was conducted to investigate the safety and efficacy of vedolizumab (selective monoclonal antibody) between young (<40 years of age) and elderly (>60 years of age) inflammatory bowel disease (IBD) patients.

From 2015 to 2019, this study was carried out and included 284 individuals who underwent vedolizumab therapy and were monitored for at least 14 weeks. Participants were allocated  into groups based on their age: 40 years or less group or 60 years or older group. At weeks 14 and 52, the endoscopic and clinical responses and infection growth were examined. 

In the elderly group, there were about 144 (82 Crohn’s disease and 62 ulcerative colitis, average age70.2  ± 7.3 years) participants. In the young group, there were 140 (83 Crohn’s disease and 57 ulcerative colitis, average age 29.6 ± 5.7 years) participants.

At week 52 remission of Crohn’s disease and ulcerative colitis, the clinical and endoscopic responses were found to be comparable between the groups, as depicted in the following table:

Among both young and elderly ulcerative colitis and Crohn’s disease patients, no significant differences were witnessed in the clinical response and remission rates at week 14 and 52 of vedolizumab therapy. The clinical response and remission rates in the young and elderly Crohn’s disease patients (a) and (b) and ulcerative colitis patients (c) and (d) cohorts at weeks 14 (a) and (c) and 52 (b) and (d), is shown below:

The corticosteroid-free remission was also comparable across the age groups. At week 52, the corticosteroid-free clinical remission in (a) Crohn’s disease (b) ulcerative colitis cohorts is depicted in the following figure:

In all the patients who were treated with vedolizumab, the previous use of anti-tumor necrosis factor (TNF) biological therapy was independently linked with poor clinical response and remission rates at week 52 (especially the elderly patients). Compared to the young cohort, more infections were witnessed in the elderly cohort, none of which were fatal (2% vs 12%).

Compared to young patients, the use of vedolizumab in elderly patients has similar clinical and endoscopic efficacy but higher rates of infections.