Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients

Objective. To compare the efficacy of MTX and MTX+TNF inhibitors (TNFis) in elderly patients with RA with that in patients of younger age. Methods. Data from two large, randomized, controlled, double-blind trials in patients with early RA using adalimumab or infliximab+MTX or MTX alone were obtained...

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Published in:Rheumatology (Oxford, England) England), 2009-12, Vol.48 (12), p.1575-1580
Main Authors: Köller, Marcus D., Aletaha, Daniel, Funovits, Julia, Pangan, Aileen, Baker, Daniel, Smolen, Josef S.
Format: Article
Language:English
Subjects:
Adalimumab
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - diagnostic imaging
Arthritis, Rheumatoid - drug therapy
Biological and medical sciences
Bones, joints and connective tissue. Antiinflammatory agents
Disease Progression
Diseases of the osteoarticular system
Drug Therapy, Combination
Elderly
Epidemiologic Methods
Female
Humans
Inflammatory joint diseases
Infliximab
Male
Medical sciences
Methotrexate
Methotrexate - therapeutic use
Middle Aged
Pharmacology. Drug treatments
Radiography
Rheumatoid arthritis
Treatment Outcome
Treatment response
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Tumour necrosis factor
Young Adult
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Summary:Objective. To compare the efficacy of MTX and MTX+TNF inhibitors (TNFis) in elderly patients with RA with that in patients of younger age. Methods. Data from two large, randomized, controlled, double-blind trials in patients with early RA using adalimumab or infliximab+MTX or MTX alone were obtained and pooled. Composite disease activity indices were calculated at baseline and 1 year of treatment, and compared in groups of patients classified by quartiles of age with the highest age group comprising 61–82 years using analysis of variance or Kruskal–Wallis test. Results. Across all age quartiles, improvement on MTX was similar with respect to changes of composite disease activity indices, assessment of physical function and X-ray progression. Likewise, TNFi+MTX had similar effects across all age groups, but the effects of the combination were more profound than those of MTX monotherapy. Also in 10% of the patients with the highest age, primarily septuagenarians, improvement was seen to a similar degree as in the younger ones. Conclusions. Responsiveness of elderly patients with RA to MTX or TNFi+MTX is similar to that observed in patients of younger age.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/kep291