Safety and effectiveness of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis : a prospective cohort study
| Autor: | G. Sequeira, João Madruga Dias, Joaquim Polido Pereira, Miguel Bernardes, Fátima Godinho, Flávio Costa, João Eurico Fonseca, Luís Miranda, Bruno Miguel Fernandes, Agna Neto, Raquel Freitas, Maura Couto, Maria José Santos, Nathalie Madeira, Mariana Santiago, Soraia Azevedo |
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| Přispěvatelé: | Repositório da Universidade de Lisboa |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Comorbidity Kaplan-Meier Estimate Disease Arthritis Rheumatoid Cohort Studies 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Older patients Internal medicine medicine Humans Pharmacology (medical) Prospective Studies 030212 general & internal medicine Adverse effect Prospective cohort study Aged Biological Products Portugal business.industry Age Factors Antibodies Monoclonal Middle Aged medicine.disease Treatment Outcome Antirheumatic Agents Rheumatoid arthritis Female Geriatrics and Gerontology Antirheumatic drugs business 030217 neurology & neurosurgery Rheumatism |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| Popis: | © Springer Nature Switzerland AG 2020 Background and objective: The number of older patients with rheumatoid arthritis is increasing, but data on drug effectiveness and safety in these patients are scarce. This study assessed the effectiveness and safety of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis. Methods: This prospective cohort study was based on data recorded in the Rheumatic Diseases Portuguese Register (Reuma.pt). Treatment persistence, European League Against Rheumatism response at 6 and 12 months, and adverse events were compared between adult (age < 65 years), old (age 65-74 years), and very old (age ≥ 75 years) patients. Results: In total, 2401 patients were included, of which 379 were old and 83 were very old. Older patients had higher disease activity at baseline (Disease Activity Score 28: 5.5 in adults, 5.7 in old patients, and 6 in very old patients; p = 0.02) and more comorbidities, with patients aged 65-74 years beginning biologic disease-modifying antirheumatic drugs later in the course of rheumatoid arthritis. Treatment persistence was similar in the three patient groups (p = 0.07). The European League Against Rheumatism response rates were comparable in the three groups at 6 months (81.6% of adults, 75.2% of old patients, and 81.8% of very old patients; p = 0.19), and inferior in old patients at 12 months. The proportion of patients who experienced adverse events was also similar in the three groups (21% of adults, 22.5% of old patients, and 22.9% of very old patients; p = 0.76), but the rate of serious adverse events was higher in old patients (1.94/100 patient-years) and very old patients (4.29/100 patient-years) compared with 1.03/100 patient-years in adult patients with rheumatoid arthritis (p < 0.05). Conclusions: Adults, old patients, and very old patients with rheumatoid arthritis benefit similarly from biologic disease-modifying antirheumatic drug treatments, although older patients have more active disease at baseline and more comorbidities. However, it is necessary to consider the risk of serious adverse events in older patients when prescribing a biologic. |
| Databáze: | OpenAIRE |
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