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Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients
Rheumatology, 10/08/09

Köller MD et al. –This study compared the efficacy of MTX and MTX+TNF inhibitors (TNFis) in elderly patients with RA with that in patients of younger age. Responsiveness of elderly patients with RA to MTX or TNFi+MTX is similar to that observed in patients of younger age

Methods

Data from 2 large, randomized, controlled, double-blind trials in patients with early RA using adalimumab or infliximab+MTX or MTX alone obtained and pooled
Composite disease activity indices calculated at baseline and 1 year of treatment
Compared in groups of patients classified by quartiles of age with highest age group comprising 61–82 years using analysis of variance or Kruskal–Wallis test

Results

Across all age quartiles, improvement on MTX similar with respect to changes of composite disease activity indices, assessment of physical function and X-ray progression
TNFi+MTX had similar effects across all age groups
Effects of combination more profound than those of MTX monotherapy
In 10% of patients with highest age, primarily septuagenarians, improvement was seen to a similar degree as in younger ones

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