Abstract
ObjectivesTo assess whether age, at the beginning of biologic treatment, is associated with the time a first adverse event (AE) appears in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA).MethodsAll patients in the BIOBADASER registry diagnosed with RA, AS, and PsA, and classified as young (< 25 years old), adult (25–64 years old), elderly (65–75 years old) or very elderly (> 75 years old) at start of biological treatment were included. Factors associated with the appearance of a first AE using adjusted incidence rate ratios (IRR) (Poisson regression) were analyzed. Survival to first AE was studied by Kaplan-Meier analysis and hazard ratios (HR) by Cox regression.Results2483 patients were included: 1126 RA, 680 PsA, and 677 AS. Age group stratification was as follows: 63 young, 2127 adults, 237 elderly, and 56 very elderly. Regression model revealed an increased probability of suffering a first AE at age 65 years or older [IRR elderly: 1.42 (CI95% 1.13–1.77)]. Other characteristics associated with AE were female gender, the use of DMARDs, including methotrexate, the presence of comorbidities, and the time of disease duration. Factors that had the greatest impact on survival over a first AE were age > 75 years [HR 1.50 (1.01–2.24)] and female gender [HR 1.42 (1.22–1.64)].ConclusionAge at the start of treatment and female gender are key factors associated with the appearance of a first AE with biologics. Other factors related to patient status and treatment were also associated with a first AE in rheumatic patients treated with biologics.
Highlights
Demographic trends are shaping the rapidly growing population aged 65 years and older throughout Western society [1]
Information was obtained from BIOBADASER, a national prospective registry of patients with rheumatic diseases treated with biologic diseasemodifying antirheumatic drugs, including biosimilars and targeted synthetic disease-modifying antirheumatic drugs, either with approved or off-label indications
A total of 2483 patients were included in this study: 1126 (45.34%) rheumatoid arthritis (RA), 680 (27.39%) psoriatic arthritis (PsA), and 677 (27.27%) ankylosing spondylitis (AS)
Summary
Demographic trends are shaping the rapidly growing population aged 65 years and older throughout Western society [1]. This has enabled patients with chronic arthritis to reach advanced ages, as well as the appearance of rheumatic diseases in more elderly individuals. In 2017, a retrospective study [3] reported that the mean age of RA onset had significantly increased over the previous decade, from 55.8 years in 2002–2003 to 59.9 years in 2012–2013, with a corresponding shift in peak age from 50–59 to 60–69 years during that same time period. Previous epidemiological series reported a prevalence for late-onset ankylosing spondylitis between 3 and 8% [5], the real prevalence of late-onset spondyloarthritis remains little known
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