Influence of age on the occurrence of adverse events in rheumatic patients at the onset of biological treatment: data from the BIOBADASER III register

• Published in: Arthritis research & therapy Vol. 22; no. 1; p. 143
• Main Authors: Vela, Paloma, Sanchez-Piedra, Carlos, Perez-Garcia, Carolina, Castro-Villegas, María C, Freire, Mercedes, Mateo, Lourdes, Díaz-Torné, Cesar, Bohorquez, Cristina, Blanco-Madrigal, Juan M, Ros-Vilamajo, Inmaculada, Gómez, Silvia, Caño, Rocio, Sánchez-Alonso, Fernando, Díaz-González, Federico, Gómez-Reino, Juan J
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.06.2020; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Analysis; Ankylosing spondylitis; Antirheumatic Agents - adverse effects; Arthritis; Arthritis, Psoriatic - drug therapy; Arthritis, Psoriatic - epidemiology; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Biological products; Biological Products - therapeutic use; Biologics; Care and treatment; Clinical trials; Comorbidity; Elderly-onset rheumatoid arthritis; Female; Gender; Health aspects; Humans; Immunotherapy; Male; Methotrexate; Methotrexate - therapeutic use; Middle Aged; Older people; Patients; Population; Psoriasis; Psoriatic arthritis; Rheumatic diseases; Rheumatoid arthritis; Rheumatoid factor; Spondylitis, Ankylosing - drug therapy; Spondylitis, Ankylosing - epidemiology; Tumor necrosis factor-TNF; Young Adult; Elderly-onset rheumatoid arthritis; Biologics; Rheumatoid arthritis; Ankylosing spondylitis; Psoriatic arthritis
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-020-02231-x

To 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). All 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. 2483 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)]. Age 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.