Drug efficacy and safety of biologics and Janus kinase inhibitors in elderly patients with rheumatoid arthritis

Ebina, Kosuke

Modern Rheumatology, 2022, 32(2), 256-262

Number of Access:254（2025-09-03 11:38 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/93211

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Title
Drug efficacy and safety of biologics and Janus kinase inhibitors in elderly patients with rheumatoid arthritis
Creator
NRID
1000070612076 1000070612076
researchmap permalink
k-ebina k-ebina
Scopus Author ID
8415453300 8415453300
ORCID
0000-0002-2426-1024 0000-0002-2426-1024
CreatorName
Ebina, Kosuke
Subject
Biologics
efficacy
elderly patient with rheumatoid arthritis
Janus kinase inhibitors
safety
Description
This is a pre-copyedited, author-produced version of an article accepted for publication in The Modern Rheumatology following peer review. The version of record, Ebina K.. Drug efficacy and safety of biologics and Janus kinase inhibitors in elderly patients with rheumatoid arthritis. Modern Rheumatology 32(2), 256-262, (2022); is available online at: https://academic.oup.com/mr/article/32/2/256/6348532 and https://doi.org/10.1093/mr/roab003.
Abstract
Elderly patients with rheumatoid arthritis (RA) are frequently associated with higher disease activity and impaired physical function, although they show intolerance for conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), such as methotrexate, because of their comorbidities. However, the present treatment recommendation based on randomized controlled trials is not distinguished by age or comorbidities. Therefore, this review aimed to investigate the efficacy and safety of biological DMARDs (bDMARDs) and Janus kinase inhibitors (JAKi) in elderly patients. Present bDMARDs, including tumor necrosis factor inhibitors (TNFi), cytotoxic T lymphocyte-associated antigen-4-immunoglobulin (abatacept), interleukin (IL)-6 receptor antibody (tocilizumab and salirumab), and anti-CD20 antibody (rituximab), may be similarly or slightly less effective or safe in elderly patients compared with younger patients. Oral glucocorticoid use, prolonged disease duration, and very old patients appear to be associated with an increased risk of adverse events, such as serious infection. Some recent cohort studies demonstrated that non-TNFi showed better retention than TNFi in elderly patients. Both TNFi and non-TNFi agents may not strongly influence the risk of adverse events such as cardiovascular events and malignancy in elderly patients. Regarding JAKi, the efficacy appears to be similar, although the safety (particularly for serious infections, including herpes zoster) may be attenuated by aging.
Publisher
Oxford University Press
Source Title
Modern Rheumatology
Volume (Issue)
32(2)
Page
256-262
Date of Issued
2022-03-01
Language
English
Handle URL
https://hdl.handle.net/11094/93211
PISSN
14397595
eISSN
14397609
Relation.isVersionOf
DOI (Publisher Version)
https://doi.org/10.1093/mr/roab003
Access Rights
open access
CopyRight
© 2022 Japan College of Rheumatology. Published by Oxford University Press. All rights reserved.
oaire:version
Accepted Manuscript
Category
学術雑誌論文 Journal Article