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Drug Survival of Biologic Therapy in Elderly Patients With Rheumatoid Arthritis Compared With Nonelderly Patients: Results From the Korean College of Rheumatology Biologics Registry

 Seung Min Jung  ;  Sang-Won Lee  ;  Jason Jungsik Song  ;  Sung-Hwan Park  ;  Yong-Beom Park 
 JCR-JOURNAL OF CLINICAL RHEUMATOLOGY, Vol.28(1) : e81-e88, 2022-01 
Journal Title
Issue Date
Aged ; Antirheumatic Agents* / therapeutic use ; Arthritis, Rheumatoid* / diagnosis ; Arthritis, Rheumatoid* / drug therapy ; Biological Products* / therapeutic use ; Biological Therapy ; Female ; Humans ; Longitudinal Studies ; Male ; Medication Adherence / statistics & numerical data* ; Middle Aged ; Registries ; Republic of Korea / epidemiology ; Rheumatology ; Treatment Outcome
Objective: Although the proportion of elderly patients with rheumatoid arthritis (RA) is increasing, the persistency of biologic therapy in elderly patients requires additional investigation. This study evaluated the drug survival of biologic therapy and associated factors in elderly compared with nonelderly patients.

Methods: This longitudinal observational study included RA patients who were enrolled in the Korean College of Rheumatology Biologics Registry (NCT01965132, started from January 1, 2013) between 2013 and 2015. We compared the retention rate of biologic therapy between elderly (age ≥70 years) and nonelderly (age <70 years) patients, and investigated the causes and predictors of biologic withdrawal in both groups.

Results: Of 682 patients, 122 were aged 70 years or older. The retention rate of biologic therapy at 24 months was 57.8% and 46.5% in nonelderly and elderly patients, respectively (p = 0.027). Biologic withdrawal due to adverse events and inefficacy within 24 months was not significantly different between the 2 groups, although adverse events were more common in elderly patients (20.6% vs 12.8%, p = 0.360). Drug withdrawal due to patient refusal was more common in elderly patients (9.8% vs 1.8%, p < 0.001). In elderly patients, biologic withdrawal was associated with current smoking and older age at disease onset, whereas the use of tumor necrosis factor inhibitors, nonuse of methotrexate, and combination of corticosteroid were important in nonelderly patients.

Conclusions: Elderly RA patients are more likely to discontinue biologic agents within 24 months. To increase the retention rate of biologic therapy, rheumatologists should consider patient characteristics before and during biologic therapy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Jason Jungsik(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Jung, SeungMin(정승민) ORCID logo https://orcid.org/0000-0003-3465-2181
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