title: Efficacy and safety of rituximab in elderly patients with rheumatoid arthritis enrolled in a French Society of Rheumatology registry.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy and safety of rituximab (RTX) as a function of patient age.
  
  
  METHODS
  We included all rheumatoid arthritis patients in the AutoImmunity and Rituximab registry with a 2-year followup.
  
  
  RESULTS
  Of the 1,709 patients, 191 were age ≥75 years, 417 were ages 65–74 years, 907 were ages 50–64 years, and 194 were age <50 years. At baseline, the elderly and very elderly patients presented with longer disease duration, a higher incidence of erythrocyte sedimentation rate and C-reactive protein level, a lower incidence of previous tumor necrosis factor α (TNFα) therapy, and a smaller number of previously used TNFα agents. Disease activity, rheumatoid factor (RF), or anti–cyclic citrullinated peptide (anti-CCP) antibodies and corticosteroid therapy were not statistically different among the groups. At 24 months, no significant difference was shown among the groups for RTX discontinuation rates (36.1% if age <50 years, 32.6% if ages 50–64 years, 34.5% if ages 65–74 years, and 32.5% if age >75 years). The reasons for discontinuation (inefficacy, adverse events) were the same in all 4 groups. Infections were more common in the elderly. Patients ages 65–75 years were more likely to be good responders than nonresponders at 1 year of followup than patients age ≥75 years (odds ratio 3.81, 95% confidence interval 1.14–12.79) after adjustment on disease duration, RF/anti-CCP positivity, corticosteroids, anti-TNF use, and baseline Disease Activity Score in 28 joints (DAS28). After the sixth month, the decrease in DAS28 score was less marked in the population age >75 years than in the group age <50 years.
  
  
  CONCLUSIONS
  The efficacy and safety of RTX is affected by age.
authors.forename: Sarah
authors.initials: S
authors.lastname: Payet
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.forename: Elodie
authors.initials: E
authors.lastname: Perrodeau
authors.forename: Thomas
authors.initials: T
authors.lastname: Bardin
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.forename: Thierry
authors.initials: T
authors.lastname: Shaeverbeke
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D000069283:Rituximab; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab