PMID- 27507033
OWN - NLM
STAT- MEDLINE
DCOM- 20171128
LR  - 20240325
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 17
DP  - 2016 Aug 9
TI  - Drug retention and safety of TNF inhibitors in elderly patients with rheumatoid 
      arthritis.
PG  - 333
LID - 10.1186/s12891-016-1185-6 [doi]
LID - 333
AB  - BACKGROUND: The concerns about the development of adverse events (AEs) in elderly 
      RA patients as a result of age-related changes in drug metabolism and the 
      presence of comorbid illnesses are emphasizing due to increasing prevalence of 
      rheumatoid arthritis (RA) in old age. However, they tend to be inadequately 
      represented in RA clinical trials because of the exclusion criteria that are 
      commonly applied. The tolerability and safety of TNF inhibitors in elderly 
      patients have not been also evaluated in clinical practice. This study aimed to 
      evaluate the retention rate and safety of TNF inhibitors (TNFI) in elderly RA 
      patients. METHODS: Total 429 RA patients (838 person-years [PYs]) treated with 
      TNFI from a retrospective biologic DMARDs registry. Patients were divided into an 
      elderly (age >/=60 years) and a younger group (<60 years). The drug retention rates 
      of both groups were compared using Kaplan-Meier curves. Potential predictors of 
      TNFI discontinuation in the elderly were examined using Cox regression analysis. 
      The incidence rate (IR) of serious adverse events (SAEs) in the elderly group was 
      compared to that of the young group. RESULTS: Of the patients, 24.9 % (n = 107, 
      212 PYs) were in the elderly group. Regarding the retention rates of TNFI in 
      3 years, there was no significant difference between the elderly and younger 
      group (p = 0.33). The major cause of discontinuation in elderly patients was AE 
      (34.3 %), whereas that was drug ineffectiveness (41.7 %) in younger patients. Age 
      (HR 1.09, CI 1.02-1.16) was a predictor of discontinuation, while the presence of 
      comorbidity (HR 0.37, CI 0.15-0.91) had a protective effect against drug 
      discontinuation in the elderly. The IR of SAEs in the elderly (6.13/100 PYs) was 
      higher than in the younger group (5.11/100 PYs). CONCLUSIONS: The retention rate 
      of TNFI in the elderly was comparable with that in younger patients. The major 
      cause of discontinuation in the elderly patients was AEs, while it was drug 
      ineffectiveness in younger patients. The IR of SAEs in the elderly was higher 
      than in the younger patients.
FAU - Cho, Soo-Kyung
AU  - Cho SK
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea.
FAU - Sung, Yoon-Kyoung
AU  - Sung YK
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea.
FAU - Kim, Dam
AU  - Kim D
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea.
FAU - Won, Soyoung
AU  - Won S
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea.
FAU - Choi, Chan-Bum
AU  - Choi CB
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea.
FAU - Kim, Tae-Hwan
AU  - Kim TH
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
FAU - Jun, Jae-Bum
AU  - Jun JB
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
FAU - Yoo, Dae-Hyun
AU  - Yoo DH
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea.
FAU - Bae, Sang-Cheol
AU  - Bae SC
AD  - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 
      Seoul, 133-792, South Korea. scbae@hanyang.ac.kr.
AD  - Clinical Research Center for Rheumatoid Arthritis, Seoul, South Korea. 
      scbae@hanyang.ac.kr.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160809
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Antirheumatic Agents/*adverse effects
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Medication Adherence
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
PMC - PMC4977640
OTO - NOTNLM
OT  - Drug retention rate
OT  - Elderly
OT  - Rheumatoid arthritis
OT  - Safety
OT  - TNF inhibitor
EDAT- 2016/08/11 06:00
MHDA- 2017/11/29 06:00
PMCR- 2016/08/09
CRDT- 2016/08/11 06:00
PHST- 2016/01/01 00:00 [received]
PHST- 2016/07/28 00:00 [accepted]
PHST- 2016/08/11 06:00 [entrez]
PHST- 2016/08/11 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/08/09 00:00 [pmc-release]
AID - 10.1186/s12891-016-1185-6 [pii]
AID - 1185 [pii]
AID - 10.1186/s12891-016-1185-6 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2016 Aug 9;17:333. doi: 10.1186/s12891-016-1185-6.