New research suggests patients with young- and elderly-onset rheumatoid arthritis (RA), who initiate biological disease-modifying antirheumatic drugs (bDMARDs), have similar improvements in clinical disease at 48 weeks after starting therapy.
The study included 7,183 adults with RA who were enrolled in a Japanese multicentre observational registry between September 2009 and December 2017. Participants had a ≥3.2 disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) when initiating bDMARDs. The primary outcome was Clinical Disease Activity Index (CDAI) score at 48 weeks.
Of 989 bDMARDs initiators, 364 were identified as elderly-onset rheumatoid arthritis (EORA).
After adjusting for differences in baseline characteristics between the two age groups, researchers found no significant differences in the CDAI scores at 48 weeks. They did find a trend toward lower index remission rates in the elderly-onset group, but said low disease activity/remission rates were similar between the two groups. Drug maintenance and adverse events discontinuation rates were similar.
Author, Dr Sadao Jinno said the findings suggest biologics can be used for those with elderly-onset RA as effectively as for those with young-onset RA. "Clinicians should choose wisely which patients with elderly-onset RA are safely treated with biologics given that they are still at risk of developing adverse events, especially infections,” Dr Jinno added.