title: Medical management of inflammatory bowel disease in the elderly: balancing safety and efficacy.
abstract: The medical management of inflammatory bowel disease (IBD) in the older patient extends beyond luminal disease activity. Factors such as comorbidity, functional status, polypharmacy, and age-related changes in physical reserve and drug metabolism may affect therapeutic decision making. The older patient with IBD is more susceptible to disease-related complications and also to adverse events with therapy, particularly immunosuppression. Appropriate medication selection along with multidisciplinary care, factoring not only disease activity but also these age-related risk factors, may improve therapeutic outcomes and decrease adverse events to therapy.
authors.affiliation: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, The David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 365C, Los Angeles CA 90095, USA. Electronic address: cha@mednet.ucla.edu.
authors.forename: Christina Y
authors.initials: CY
authors.lastname: Ha
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000493:pharmacokinetics; D001711:Biotransformation; D015897:Comorbidity; D017281:Cost of Illness; D004347:Drug Interactions; D016903:Drug Monitoring; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000493:pharmacokinetics; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D054539:Medication Therapy Management; D019804:Mesalamine / Q000009:adverse effects / Q000493:pharmacokinetics; D019338:Polypharmacy; D018570:Risk Assessment
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007155:Immunologic Factors; D019804:Mesalamine
keywords: Adverse events; Coordinated care; Infection; Inflammatory bowel disease; Polypharmacy