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Safety and effectiveness of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis : a prospective cohort study

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dc.contributor.authorFreitas, Raquel
dc.contributor.authorGodinho, Fátima
dc.contributor.authorMadeira, Nathalie
dc.contributor.authorFernandes, Bruno Miguel
dc.contributor.authorCosta, Flávio
dc.contributor.authorSantiago, Mariana
dc.contributor.authorNeto, Agna
dc.contributor.authorAzevedo, Soraia
dc.contributor.authorCouto, Maura
dc.contributor.authorSequeira, Graça
dc.contributor.authorDias, João Madruga
dc.contributor.authorBernardes, Miguel
dc.contributor.authorMiranda, Luís
dc.contributor.authorPolido Pereira, Joaquim
dc.contributor.authorFonseca, João Eurico
dc.contributor.authorSantos, Maria
dc.date.accessioned2021-03-03T17:45:30Z
dc.date.available2021-03-03T17:45:30Z
dc.date.issued2020
dc.description© Springer Nature Switzerland AG 2020pt_PT
dc.description.abstractBackground and objective: The number of older patients with rheumatoid arthritis is increasing, but data on drug effectiveness and safety in these patients are scarce. This study assessed the effectiveness and safety of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis. Methods: This prospective cohort study was based on data recorded in the Rheumatic Diseases Portuguese Register (Reuma.pt). Treatment persistence, European League Against Rheumatism response at 6 and 12 months, and adverse events were compared between adult (age < 65 years), old (age 65-74 years), and very old (age ≥ 75 years) patients. Results: In total, 2401 patients were included, of which 379 were old and 83 were very old. Older patients had higher disease activity at baseline (Disease Activity Score 28: 5.5 in adults, 5.7 in old patients, and 6 in very old patients; p = 0.02) and more comorbidities, with patients aged 65-74 years beginning biologic disease-modifying antirheumatic drugs later in the course of rheumatoid arthritis. Treatment persistence was similar in the three patient groups (p = 0.07). The European League Against Rheumatism response rates were comparable in the three groups at 6 months (81.6% of adults, 75.2% of old patients, and 81.8% of very old patients; p = 0.19), and inferior in old patients at 12 months. The proportion of patients who experienced adverse events was also similar in the three groups (21% of adults, 22.5% of old patients, and 22.9% of very old patients; p = 0.76), but the rate of serious adverse events was higher in old patients (1.94/100 patient-years) and very old patients (4.29/100 patient-years) compared with 1.03/100 patient-years in adult patients with rheumatoid arthritis (p < 0.05). Conclusions: Adults, old patients, and very old patients with rheumatoid arthritis benefit similarly from biologic disease-modifying antirheumatic drug treatments, although older patients have more active disease at baseline and more comorbidities. However, it is necessary to consider the risk of serious adverse events in older patients when prescribing a biologic.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationDrugs Aging. 2020 Dec;37(12):899-907pt_PT
dc.identifier.doi10.1007/s40266-020-00801-xpt_PT
dc.identifier.eissn1179-1969
dc.identifier.issn1170-229X
dc.identifier.urihttp://hdl.handle.net/10451/46632
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://www.springer.com/journal/40266pt_PT
dc.titleSafety and effectiveness of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis : a prospective cohort studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage907pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage899pt_PT
oaire.citation.titleDrugs & Agingpt_PT
oaire.citation.volume37pt_PT
person.familyNamePolido Pereira
person.familyNameFonseca
person.familyNameSantos
person.givenNameJoaquim
person.givenNameJoão
person.givenNameMaria Jose
person.identifier676523
person.identifier.ciencia-id9812-232A-B282
person.identifier.ciencia-idF310-B85D-57C7
person.identifier.ciencia-id441A-CD98-8FD6
person.identifier.orcid0000-0002-7188-8516
person.identifier.orcid0000-0003-1432-3671
person.identifier.orcid0000-0002-7946-1365
person.identifier.scopus-author-id7101983519
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication757607f2-5ab2-4d9e-a968-ce37a7b9113c
relation.isAuthorOfPublication1772dc12-7c55-4c76-ae2d-c23270172480
relation.isAuthorOfPublication288e25e9-3f56-4cab-afff-0cda5478f1ba
relation.isAuthorOfPublication.latestForDiscovery1772dc12-7c55-4c76-ae2d-c23270172480

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