title: Neutropenia in the Elderly: A Rheumatology Perspective.
abstract: The majority of rheumatic diseases are chronic and require long-term use of disease-modifying agents to confer the best chance of controlling the disease. A significant proportion of these drugs have a risk, albeit small, of potentially serious side effects, such as neutropenia; therefore, there has been an understandable concern over the use of potentially toxic rheumatic drugs in the elderly. Factors that may contribute to this concern include age, pre-existing co-morbidities, polypharmacy, difficulty in monitoring side effects, and patient perception. The risk of using such medication needs to be balanced with their benefits in controlling chronic disease. This review discusses how rheumatic disease and anti-rheumatic medication are associated with neutropenia in an older age group. Of the rheumatic diseases, we give special focus to rheumatoid arthritis and the use of methotrexate, as well as touching on management considerations in neutropenia.
authors.affiliation: Rheumatology Department, University of Southampton Hospital, Southampton, UK.
authors.forename: Su-Ann
authors.initials: SA
authors.lastname: Yeoh
authors.affiliation: Rheumatology Department, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK. christinefox@doctors.org.uk.
authors.forename: Christine
authors.identifier: 0000-0002-2873-8213
authors.initials: C
authors.lastname: Fox
authors.affiliation: Rheumatology Department, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Hull
mesh_terms: D000368:Aged; D000375:Aging / Q000097:blood; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D006801:Humans; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology; D019338:Polypharmacy; D012216:Rheumatic Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D012219:Rheumatology / Q000639:trends*
chemical_list: D018501:Antirheumatic Agents