RETENTION RATE OF BIOLOGIC AND TARGETED SYNTHETIC ANTI-RHEUMATIC DRUGS IN ELDERLY PATIENTS AFFECTED BY RHEUMATOID ARTHRITIS: DATA FROM ITALIAN GISEA REGISTRY in Annals of the Rheumatic Diseases
2023
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (22)Vedi tutti...
Manfredi A
Azienda Ospedaliera Universitaria Policlinico di Modena, Rheumatology Unit, MOdena, Italy
Iannone F
Azienda Ospedaliera Universitaria Policlinico di Bari, Dipartimento di Emergenza e Trapianto d'organi, UOC di Reumatologia, Bari, Italy
Bugatti S
University of Pavia, Department of Internal Medicine and Therapeutics, Pavia, Italy
et alii...
Abstract
Background: An increased number of elderly patients with rheumatoid arthritis (RA) has been observed in the last years mainly due to the increase of life expectancy. In this group it is possible to include two different categories: patients with onset of RA in advanced age (60-65 years old), and patients with an early occurrence of RA aged with the disease. For all elderly patients many factors such as: comorbidities and polytherapy, extra-articular manifestations of RA, and the process of immune-senescence can increase frailty and difficulties for rheumatologist in management of RA. Although patients with late onset of RA frequently show more aggressive articular involvement and systemic manifestations, literature data suggest that rheumatologists tend to treat elderly patients less aggressively. Moreover, they delay treat to target approach with less frequent use of biologic drugs and prolonged use of steroids or NSAIDsThe improvement of knowledge about persistence of different drugs and associated patients' profiles could suggest more specific treatment strategies encouraging the correct management of RA elderly patients in clinical practice. Objectives: Aim of the study was to evaluate the retention rate at two years of treatment with biologic or targeted synthetic (ts) DMARDs, namely TNF inhibitors, anti-IL6, anti-CD20, Abatacept and Janus kinases inhibitors (JAKis), in patients with RA who received a targeted therapy over 65 years of age. Methods: Data were extracted from the GISEA registry (Gruppo Italiano Studio Early Arthritis), selecting RA patients in which biologic-or ts-DMARDs were prescribed over 65 years of age. Global persistence in therapy and 2-year retention rate were evaluated by mean of Cox regression. Then, a multivariate analysis was performed to evaluate factors associated to the discontinuation of the treatment. Results: We analysed data of 1221 patients (F/M ratio 966/255). Therapies prescribed were: TNFis in 362 pts (29.6%), anti-IL
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DOI : 10.1136/annrheumdis-2023-eular.6215
Keywords
abatacept; CD20 antibody; cyclic citrullinated peptide antibody; disease modifying antirheumatic drug; endogenous compound; glucocorticoid; interleukin 6; Janus kinase; methotrexate; rheumatoid factor; tumor necrosis factor inhibitor; aged; clinical practice; comorbidity; conference abstract; controlled study; DAS28; disease activity score; drug combination; drug therapy; female; gender; human; line of treatment; major clinical study; male; molecularly targeted therapy; prospective study; rheumatoid arthritis; rheumatologist; univariate analysis;