Risk factors of adverse events during treatment in elderly patients with rheumatoid arthritis: an observational study.
OBJECTIVE
The risk factors of adverse events during a number of currently used treatments for rheumatoid arthritis (RA) in elderly patients were examined.


METHODS
A retrospective observational study was conducted for 300 elderly RA patients registered in December 2009 at Sasebo Chuo Hospital, Japan, and the adverse events during the treatments for RA were assessed.


RESULTS
The average age of the patients was 74.3 ± 5.8 years. The Steinbrocker stage was IV in almost one-half of the patients. Methotrexate (MTX) was used in 54.0% of patients and biologics in 23.0% of patients. Adverse events occurred in 103 patients (34.3%). The most common adverse events were infections (46.6%), including pneumonia (21.4%). Multiple logistic analyses revealed that the factors significantly related to infection were advanced Steinbrocker stage and the existence of respiratory diseases, and that of pneumonia was the existence of diabetes mellitus (DM).


CONCLUSIONS
The elderly RA patients with advanced stage, respiratory diseases or DM should be monitored for infections, including pneumonia, carefully during treatment.
Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan.|Deparment of Rheumatology, Nagasaki Medical Center, Kubara Omura-city, Japan.
Nozomi
N
Iwanaga
Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Kazuhiko
K
Arima
Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan.
Kaoru
K
Terada
Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan.
Yukitaka
Y
Ueki
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Yoshiro
Y
Horai
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Takahisa
T
Suzuki
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Yoshikazu
Y
Nakashima
Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Shin-Ya
SY
Kawashiri
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Kunihiro
K
Ichinose
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Mami
M
Tamai
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Hideki
H
Nakamura
Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Kiyoshi
K
Aoyagi
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Atsushi
A
Kawakami
Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.|Department of Rehabilitation Sciences;, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan.
Tomoki
T
Origuchi
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011014:Pneumonia / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents
adverse event; drug treatment; rheumatoid arthritis