Seniors Who Start Thiopurine Therapy for IBD Have Higher Risk for Adverse Events

A study in Alimentary Pharmacology and Therapeutics found seniors with inflammatory bowel disease are at an elevated risk for adverse events (AEs) as they start thiopurine treatment, reports Medical Xpress . The researchers investigated two cohorts who started thiopurine use between 18 and 50, and who started at more than 60 years old. Analysis showed 43.4 percent of subjects in the over-60 group had at least one AE, versus 29.7 percent in the control group. The senior cohort also had higher rates of myelotoxicity, digestive intolerance, and hepatotoxicity, as well as higher incidence of infections and neoplasms. The median duration of therapy was 13 months in the older group compared to 32 months among the controls, and thiopurines were halted due to AEs other than infections and neoplasms occurring more often in the older cohort. Female gender also was an independent risk factor for most AEs. "Our findings . . . suggest that dosing guidelines should recommend consideration of lower starting doses or close monitoring of drug metabolites in senior and female populations," the researchers noted.