Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: The elderly rheumatoid arthritis (RA) patients have declined physical performances and various complications. The efficacy of the biological DMARDs may decrease in elderly RA patients because not enough dosage of MTX could be used for them, due to some concerns such as risks of the infection increasing. The purpose of this study was to examine the efficacy, safety and continuation rate of abatacept(ABT) in elderly patients with RA.
Methods: sixty-three RA patients who had received ABT in Saitama Medical University Hospital between Oct. 2010 and May 2016 were divided into 2 groups. One was 64 years old and under (n=31), the other was 65 years old and over (n=32). In these 2 groups, we examined the retrospective evaluation of the patients’ background, disease activity, decline in physical performance, reduction of methotrexate (MTX) or prednisolone (PSL) dose, safety and continuation rate of ABT.
Results: In the patients background (younger group/elderly group), mean age of onset (46/60 year-old), rate of female (83.9/84.4%), naïve rate of biological DMARDs (51.6/28.1%), mean disease duration (7.9/12.1 years), rate of MTX use (64.5/37.5% p=0.045), rate of PSL use (64.5/87.5% p=0.041), mean dose of MTX (5.4/3.1mg/week), mean dose of PSL (5.0/5.1mg/day), DAS28-ESR4 (5.53/5.84)、and HAQ (1.13/1.67 p=0.046), positive rate of RF (74.2/93.8% p=0.043) were observed. The elderly group showed higher HAQ (p=0.046) than the younger group. In effectiveness, DAS28-ESR4 and HAQ significantly decreased in both groups for the observational period of one year after initiation of ABT therapy (P<0.05). ABT therapy did not reduce the dose of MTX for one year, while reduction of the dose of PSL was observed in both groups. There were no significant differences in the continuation rate between the younger (87.1%) and the elderly group (75.0%). The cancellation reason of ABT (younger group/elderly group) were due to adverse events (6.5/12.5％), ineffective (6.5/6.3％), remission (0.0/3.1％) one year after ABT started.
Conclusion: The ABT treatment in the elderly RA patients was suggested useful as much as in the younger patients regarding the effectiveness, the reduction of PSL dose, and the continuation rate.
To cite this abstract in AMA style:Matsuda M, Asanuma YF, Kouzu N, Mimura T. Analysis of the Efficacy, Safety and Continuation Rate of Abatacept in Elderly Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/analysis-of-the-efficacy-safety-and-continuation-rate-of-abatacept-in-elderly-patients-with-rheumatoid-arthritis/. Accessed September 20, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-the-efficacy-safety-and-continuation-rate-of-abatacept-in-elderly-patients-with-rheumatoid-arthritis/