The safety of anti-TNF agents in the elderly.
Rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis are commonly thought of as inflammatory diseases that affect younger individuals. Although the initial presentation of these diseases is common in a patients twenties or thirties, they usually persist for the duration of the patients life. In addition, up to one-third of patients with RA have disease onset after 60 years of age. Anti-TNF-a therapies now have well-recognized safety profiles that have been demonstrated in the usual clinical trial populations for these diseases, but such populations under-represent patients > or =65 years of age. This retrospective study aims to determine the safety profiles for etanercept, infliximab and adalimumab in patients of 65 years or more, undergoing anti-TNF treatment for an active inflammatory disease such as rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis, or skin disease like psoriasis. Our data show that admitting elderly patients into anti-TNF therapeutic regimens is a safe option and that it grants these patients access to the best current therapeutic option, possibly leading to better disease outcome. Quality of life in elderly patients affected by arthritis or psoriasis, often reduced by comorbidities, is as important as quality of life in younger patients. Applying the recommended screening before using biological treatment helps to reduce adverse events related to the therapy, and the application of the same screening in elderly patients seems to lead to comparable results.
Migliore
A
A
UOS of Rheumatology, S. Pietro FBF Hospital, Research Center S. Pietro, Rome, Italy. albertomigliore@terra.es
Bizzi
E
E
Laganà
B
B
Altomonte
L
L
Zaccari
G
G
Granata
M
M
Canzoni
M
M
Marasini
B
B
Massarotti
M
M
Massafra
U
U
Ranieri
M
M
Pilla
R
R
Martin
L S
LS
Pezza
M
M
Vacca
F
F
Galluccio
A
A
D000068879:Adalimumab; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D003257:Consumer Product Safety; D000068800:Etanercept; D005260:Female; D006297:Health Services Accessibility; D006299:Health Services for the Aged; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007249:Inflammation / Q000188:drug therapy* / Q000276:immunology; D000069285:Infliximab; D008297:Male; D018579:Patient Selection; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept