| etext">Concerns regarding the relative safety of | | | | both groups. |
| TNF inhibiting drugs has somewhat limited their use in | | | | There also were no differences in the mean change |
| older patients with rheumatoid arthritis (RA). The | | | | in Disease Activity in 28 Joints ratings at 2 years. This |
| perception has been that older patients are more | | | | measurement, called the Disease Activity Scale, is a |
| likely to have side-effects. These potential side | | | | quick and easy measurement of the amount of |
| effects include an increased rate of infection, | | | | active rheumatoid arthritis a patient has at any given |
| increased problems related to bone marrow or liver | | | | time. |
| toxicity, the development of a multiple-sclerosis like | | | | However, Health Assessment Questionnaire (HAQ) |
| syndrome, and reactivation of tuberculosis. | | | | scores improved significantly less in elderly patients. |
| A recent study though has provided data indicating | | | | This was essentially due to lower scores in those |
| that most patients aged 65 years or more with | | | | aged more than 75 years. Health Assessments in |
| rheumatoid arthritis (RA) appear to tolerate | | | | older patients are generally worse than younger |
| anti-tumor necrosis factor (anti-TNF) therapy well. | | | | patients. This is because of the multiple health |
| Data from 1571 RA patients who had received at | | | | problems patients have as they get older. |
| least 1 dose of anti-TNF agents over a 10-year | | | | The conclusion made by the researchers is that age |
| period were evaluated by Swiss researchers. | | | | in itself should not interfere with the decision to treat |
| Of this group, 344 were aged 65 years or more at | | | | elderly patients with RA with anti-TNF agents. (Gabay |
| the time of initial treatment. A comparison was made | | | | C, et al. Arthritis Rheum 2007; 57:679-685). |
| of discontinuation rates between this group and | | | | This study should allay fears of using anti-TNF drugs |
| younger patients. Discontinuation of a therapy is done | | | | in older patients. Nonetheless it’s important to |
| for two reasons: lack of effect or toxicity. The | | | | realize that older patients often have other co-morbid |
| median time to discontinuation was about 3 years in | | | | conditions (ie. |