AUTHOR=Manfredi Andreina , Fornaro Marco , Bazzani Chiara , Perniola Simone , Cauli Alberto , Rai Alessandra , Favalli Ennio Giulio , Bugatti Serena , Rossini Maurizio , Foti Rosario , Conti Fabrizio , Lopalco Giuseppe , Scalvini Anna , Garufi Cristina , Congia Mattia , Gorla Roberto , Gremese Elisa , Atzeni Fabiola , Caporali Roberto , Iannone Florenzo , Sebastiani Marco 

TITLE=Retention rate of biologic and targeted synthetic anti-rheumatic drugs in elderly rheumatoid arthritis patients: data from GISEA registry

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1349533

DOI=10.3389/fmed.2024.1349533

ISSN=2296-858X

ABSTRACT=Objectives. An increased number of elderly individuals affected by rheumatoid arthritis (RA) has been reported, including both patients with RA onset in advanced age and patients aged with the disease.In this registry-based study, we aimed to analyse retention rate and cause of discontinuation of biologic (b) and targeted synthetic (ts)-disease modifying antirheumatic drugs (DMARDs) in RA patients over 65 years.Methods. RA patients enrolled in the Italian GISEA registry and starting a b-or a ts-DMARD over 65 years of age were included. Demographic, clinical, serologic and therapeutic features were collected.Results. 1221 elderly RA patients were analysed (mean age 71.6±5.2 years). RA was diagnosed before 65 years in 72.5% of cases, a 60.6% of patients experienced a previous b-or ts-DMARD. In patients older than 65 initiating a new b-or ts-DMARDS, tumour necrosis factor alpha inhibitors (TNFi) were prescribed in 29.6% of patients, abatacept in 24.8%, anti-interleukin 6 receptor antagonists (anti-IL6R) in 16.3%, janus kinases inhibitors (JAKi) in 24.9%, and rituximab in 4.4%. The main causes of discontinuation were primary or secondary inadequate response (66.1%). Median retention rate for all treatments was 181.3 weeks. A statistically higher retention rate was observed for abatacept when compared to TNFi (p=0.02), JAKi (p<0.001), and anti-IL6R (p<0.001), and for TNFi versus JAKi (p=0.013).We described, in real-life setting, elderly RA patients treated with a biologic or a ts-DMARD in Italy. Loss of efficacy was the main cause of discontinuation, and DMARDs safety profile suggests that age don't contraindicate their use. Our study reinforced that control of disease activity is mandatory.