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Tumour Necrosis Factor-alpha Antagonists in the Management of Rheumatoid Arthritis in the Elderly: A Review of Their Efficacy and Safety
Drugs & Aging, 08/19/09

Radovits BJ et al. – This review discusses the currently available evidence relating to the efficacy and safety of anti–TNFalpha medication in RA patients aged >=65 years treated in clinical trials and observational studies.

• Despite a slightly less robust effect in elderly patients, anti–TNFalpha treatment has a similar long–term efficacy in patients aged >=65 years and patients aged <65 years.
• The majority of the study results showed that anti–TNFalpha treatment does not elevate the risk of infections beyond the risk found in age–matched controls. When a moderate increase in risk was found, this occurred equally in elderly and younger patients.
• Furthermore, whereas anti–TNFalpha agents were found to be relatively safe in the treatment of elderly RA patients, treatment with corticosteroids significantly elevated the risk of serious infections. Corticosteroids are frequently used in elderly patients, but the evidence suggests that preference should increasingly be given to anti–TNFalpha agents, for which the expected benefits will mostly outweigh the modestly increased risks of associated adverse events.

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