Safety and efficacy of oral tacrolimus induction therapy in elderly patients with ulcerative colitis: A subanalysis of a large multicenter retrospective cohort study.

INTRODUCTION: We previously reported the findings of a multicenter retrospective cohort study investigating the efficacy of oral tacrolimus induction therapy in patients with ulcerative colitis (UC). In this subanalysis, we specifically evaluated the efficacy and safety of tacrolimus in elderly patients. METHODS: Patients with moderate-to-severe UC treated with tacrolimus between 2009 and 2017 were stratified into the elderly (≥60 years, n=34) and non-elderly (<60 years, n=182) groups. We compared the clinical remission rate at week 12, the colectomy-free survival at week 52, and the incidence of adverse events leading to treatment discontinuation between the two groups. RESULTS: Despite the higher comorbidity burden and lower baseline hemoglobin and albumin levels in the elderly group, clinical remission rates at week 12 were comparable, at 58.8% in the elderly group and 56.6% in the non-elderly group. Colectomy-free survival at week 52 did not differ significantly between elderly and non-elderly patients (91.2% vs 90.7%). Among elderly patients, those who did not achieve clinical remission demonstrated significantly higher disease activity and lower hemoglobin levels at baseline compared with those who achieved remission. The incidence of adverse events did not differ significantly between the groups. CONCLUSION: Oral tacrolimus therapy demonstrated comparable efficacy and safety between elderly and non-elderly patients, indicating its feasibility as a treatment option for the elderly.