Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Geriatric Rheumatoid Arthritis Patients Receive Anti-Tnfa Agents Later, Have Higher Disease Activity and Experience More Often Serious Adverse Events Compared to Younger Adults
Flouri1, Irini, Drosos2, Alexandros A., Boki3, Kyriaki A., Skopouli4, Fotini N., Karras5, Dimitrios, Papadopoulos6, Ioannis, Geborek7, P.
University of Crete, Heraklion, Greece
Ioannina Medical School, Ioannina, Greece
Sismanogleion General Hospital, Athens, Greece
Athens University Medical School, Athens, Greece
NIMITS, Athens, Greece
Kavala G Hospital, Kavala, Greece
Lund University, Department of Clinical Sciences, Lund, Sweden
Anti-TNFa agents are increasingly used to treat rheumatoid arthritis (RA) patients of all ages. There is still scarce data available concerning safety and efficacy of these agents in elderly patients. We aimed to explore the effectiveness and safety profile of anti-TNFa agents in geriatric patients (>= 65 years old) with rheumatoid arthritis in clinical practice.
The Hellenic Biologic Registry for Rheumatic Diseases collects efficacy and safety data from 7 Academic and State Rheumatology clinics in Greece. Demographics, disease characteristics and treatments are recorded according to a standardized evaluation protocol (South Swedish Arthritis Treatment Group protocol). This report is on behalf of the investigators of the "Hellenic Registry for Biologics in Rheumatic Diseases".
Data were analyzed for 307 geriatric (mean age 71 (SD 7) yrs) and 771 non-geriatric (49 (11)) adults with RA. At baseline geriatric patients had longer disease duration (mean 13 (SD 10) yrs) vs 9 (SD 8), p<0.001), higher activity (DAS28 6,1(1.3) vs 5.8 (1.2), p=0.008) and higher disability (HAQ 1.1 (0.6) vs 1 (0.56), p=0.007). Improvements in disease activity following treatment by the EULAR criteria was comparable for the first 2 years of treatment; however a lower percentage of geriatrics were good responders at 24 months (p=0.05).
A total of 1335 events were recorded, 404 in the geriatrics and 931 in non-geriatrics. The time on therapy up-to the reported adverse event was shorter in geriatrics (515 (446) vs 634 (530) days, p<0.001). Infections were the most common AE reported in both groups accounting for almost half of the reports. As expected, cardiovascular events were more common in geriatrics (p=0.02) while infusion reactions were more common in non-geriatrics (p=0.01). Geriatric patients had higher incidence of a serious adverse event compared to non-geriatric adults (23% vs 11%, p<0.001).
Geriatric RA patients have a delayed treatment with anti-TNFa agents while disease activity is higher. Although response rates are comparable between the two age groups, geriatric patients experience a serious adverse event more often. Physicians treating geriatric patients with anti-TNF should carefully assess for predisposing factors for infections and vascular events.
To cite this abstract, please use the following information:
Flouri, Irini, Drosos, Alexandros A., Boki, Kyriaki A., Skopouli, Fotini N., Karras, Dimitrios, Papadopoulos, Ioannis, et al; Geriatric Rheumatoid Arthritis Patients Receive Anti-Tnfa Agents Later, Have Higher Disease Activity and Experience More Often Serious Adverse Events Compared to Younger Adults [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1024