There is little data on the features of older people who begin TNF antagonist medication for rheumatoid arthritis (RA). For this study, researchers wanted to examine prescription trends in RA patients under the age of 75 vs those above the age of 75. Between 2007 and 2009, the prospective, multicenter, longitudinal, observational, population-based CORPUS-RA cohort comprised biologic-naive patients with active RA (DAS28 > 3.2) despite first-line treatment. TNF antagonist users were those who received at least one TNF antagonist during the first year of the trial. Comorbidities, inflammation (CRP and ESR), disease activity (DAS28), disability (HAQ-DI), frequency of physician visits, and therapy were compared between the 75-year-old and 75-year-old groups. They also compared patients aged 70 years or older to patients younger than 70 years to confirm the influence of the cut-off.
About 382 RA patients had complete one-year follow-up data, including 114 TNF antagonist users, 3 (6%) among the 49 patients aged 75 years or older and 111 (32%) among the 333 patients younger than 75 years (p <0.01). The disease activity in the two age groups was comparable at inclusion and one year later. Comorbidities and history of autoimmunity were more prevalent in the elderly population. When compared to younger patients, older patients got glucocorticoids more frequently (p = 0.003) and synthetic disease-modifying anti-rheumatic medicines less frequently (p = 0.01).
In senior individuals with active RA, TNF antagonists are used less frequently and glucocorticoids are utilized more frequently than in younger people. The fact that this study was undertaken in 2007–9 limits its applicability to today’s patients, and more studies in new cohorts of active RA patients should be conducted.