Influence of age on the outcome of antitumour necrosis factor alpha therapy in rheumatoid arthritis.
OBJECTIVE
To investigate the influence of age on the effectiveness and tolerance of antitumour necrosis factor alpha (TNFalpha) therapy in rheumatoid arthritis (RA).


METHODS
730 patients of the Dutch Rheumatoid Arthritis Monitoring (DREAM) register were categorised into three groups according to their age at initiation of anti-TNFalpha therapy (<45, 45-65 and >65 years). Effectiveness of anti-TNFalpha therapy was primarily assessed by longitudinal analysis of the DAS28 during the first 12 months of treatment.


RESULTS
Improvement in disease activity and physical functioning was significantly less in elderly patients, correcting for relevant confounders. Elderly patients reached the EULAR categories of good responders and remission less often than younger patients. Drug survival, co-medication use and tolerance were comparable between the three age groups.


CONCLUSIONS
Anti-TNFalpha therapy significantly reduced disease activity in all age groups of patients; however, it appeared less effective in elderly compared with younger RA patients.
Radovits
B J
BJ
Radboud University Nijmegen Medical Centre, Department of Rheumatology, PO Box 9101, Hp 470, Nijmegen 6500 HB, The Netherlands. B.Radovits@reuma.umcn.nl
Kievit
W
W
Fransen
J
J
van de Laar
M A F J
MA
Jansen
T L
TL
van Riel
P L C M
PL
Laan
R F J M
RF
D000328:Adult; D000367:Age Factors; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011358:Product Surveillance, Postmarketing / Q000379:methods; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha