PMID- 37856034
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240516
IS  - 2198-6576 (Print)
IS  - 2198-6584 (Electronic)
IS  - 2198-6576 (Linking)
VI  - 10
IP  - 6
DP  - 2023 Dec
TI  - Generation-Dependent Retention Rates and Reasons for Discontinuation of Molecular 
      Targeted Therapies in Patients with Rheumatoid Arthritis: From FIRST Registry.
PG  - 1705-1723
LID - 10.1007/s40744-023-00603-8 [doi]
AB  - INTRODUCTION: The study aimed to optimize medical care for elderly patients with 
      rheumatoid arthritis (RA) by examining the 3-year continuation rate of different 
      molecular targeted therapies across age groups in Japan, which has a significant 
      elderly population. METHODS: The study included patients with RA who started 
      molecular targeted therapies between 2013 and 2019 and divided them into three 
      age groups. The primary outcome was to assess the 3-year continuation rate of 
      each drug and analyze reasons for treatment discontinuation using inverse 
      probability of treatment weighting. RESULTS: Among 2292 patients analyzed, tumor 
      necrosis factor (TNF) inhibitors were most commonly used in those younger than 
      65 years of age (43.5%), while Janus kinase (JAK) inhibitors were also utilized 
      (17.1%). In contrast, JAK inhibitors were less frequently used in patients aged 
      75 years and older (7.8%), with cytotoxic T lymphocyte antigen 4 immunoglobulin 
      fusion proteins (CTLA4-Ig) being the most common (39.2%). JAK inhibitors and 
      anti-interleukin-6 receptor (IL-6R) antibodies had higher continuation rates than 
      other drugs in patients under 65 years (p < 0.001). For those aged 65-74 years, 
      JAK inhibitors and CTLA4-Ig had higher continuation rates (p < 0.001), while 
      among those aged 75 years and older, CTLA4-Ig and IL-6R antibodies had higher 
      continuation rates (p < 0.001). Inadequate efficacy was the main reason for 
      discontinuation in all age groups, while infection leading to discontinuation 
      increased with age. CONCLUSIONS: The study highlights the need to consider 
      different age groups separately in elderly RA care. Among patients aged 75 years 
      and older, abatacept and anti-IL-6R antibodies showed the highest continuation 
      rates, suggesting their potential suitability and efficacy for this specific age 
      cohort.
CI  - (c) 2023. The Author(s).
FAU - Kubo, Satoshi
AU  - Kubo S
AUID- ORCID: 0000-0001-9693-9263
AD  - Department of Molecular Targeted Therapies, University of Occupational and 
      Environmental Health, Japan, Kitakyushu, Japan.
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Miyazaki, Yusuke
AU  - Miyazaki Y
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Todoroki, Yasuyuki
AU  - Todoroki Y
AD  - Department of Molecular Targeted Therapies, University of Occupational and 
      Environmental Health, Japan, Kitakyushu, Japan.
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Nagayasu, Atsushi
AU  - Nagayasu A
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Kanda, Ryuichiro
AU  - Kanda R
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Aritomi, Takafumi
AU  - Aritomi T
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Matsunaga, Satsuki
AU  - Matsunaga S
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Ueno, Masanobu
AU  - Ueno M
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Miyagawa, Ippei
AU  - Miyagawa I
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Sonomoto, Koshiro
AU  - Sonomoto K
AD  - Department of Clinical Nursing, School of Health Sciences, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Hanami, Kentaro
AU  - Hanami K
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Nakayamada, Shingo
AU  - Nakayamada S
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan.
FAU - Tanaka, Yoshiya
AU  - Tanaka Y
AUID- ORCID: 0000-0002-0807-7139
AD  - The First Department of Internal Medicine, School of Medicine, University of 
      Occupational and Environmental Health, Japan, Kitakyushu, Japan. 
      tanaka@med.uoeh-u.ac.jp.
LA  - eng
GR  - 19K17919/Japan Society for the Promotion of Science, KAKENHI/
PT  - Journal Article
DEP - 20231019
PL  - England
TA  - Rheumatol Ther
JT  - Rheumatology and therapy
JID - 101674543
PMC - PMC10654306
OTO - NOTNLM
OT  - Abatacept
OT  - Anti-IL-6R antibodies
OT  - Cancers
OT  - Elderly patients with rheumatoid arthritis
OT  - JAK inhibitor
OT  - Molecular targeted therapies
OT  - TNF inhibitors
COIS- Satoshi Kubo has received speaking fees from Eli Lilly, Bristol-Myers, 
      GlaxoSmithKline, Abbvie, and also research grants from Daiichi-Sankyo, Abbvie, 
      Boehringer Ingelheim, and Astellas. Yusuke Miyazaki has received consulting fees 
      from AstraZeneca, speaking fees, and/or honoraria from Eli Lilly and 
      GlaxoSmithKline. Shingo Nakayamada has received speaking fees from Bristol-Myers, 
      UCB, Astellas, Abbvie, Eisai, Pfizer, and Takeda, and also research grants from 
      Mitsubishi-Tanabe, Novartis, and MSD. Yoshiya Tanaka has received consulting 
      fees, speaking fees, and/or honoraria from Abbvie, Daiichi-Sankyo, Chugai, 
      Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, 
      Asahi-Kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, and also 
      research grants from Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, 
      Taisho-Toyama, Kyowa-Kirin, Abbvie, and Bristol-Myers. Yasuyuki Todoroki, Atsushi 
      Nagayasu, Ryuichiro Kanda, Takafumi Aritomi, Satsuki Matsunaga, Masanobu Ueno, 
      Ippei Miyagawa, Koshiro Sonomoto, and Kentaro Hanami have nothing to declare.
EDAT- 2023/10/19 12:43
MHDA- 2023/10/19 12:44
PMCR- 2023/10/19
CRDT- 2023/10/19 11:21
PHST- 2023/08/17 00:00 [received]
PHST- 2023/09/22 00:00 [accepted]
PHST- 2023/10/19 12:44 [medline]
PHST- 2023/10/19 12:43 [pubmed]
PHST- 2023/10/19 11:21 [entrez]
PHST- 2023/10/19 00:00 [pmc-release]
AID - 10.1007/s40744-023-00603-8 [pii]
AID - 603 [pii]
AID - 10.1007/s40744-023-00603-8 [doi]
PST - ppublish
SO  - Rheumatol Ther. 2023 Dec;10(6):1705-1723. doi: 10.1007/s40744-023-00603-8. Epub 
      2023 Oct 19.