Evidence map›Paper›PMID 33205322›Full record

ArticleDrugs & aging2020

Safety and Effectiveness of Biologic Disease-Modifying Antirheumatic Drugs in Older Patients with Rheumatoid Arthritis: A Prospective Cohort Study.

Raquel Freitas, Fátima Godinho, Nathalie Madeira, Bruno Miguel Fernandes, Flávio Costa, Mariana Santiago, Agna Neto, Soraia Azevedo, Maura Couto, Graça Sequeira and 6 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 10 institutions in 1 country.

Raquel FreitasRheumatology Department, Hospital Garcia de Orta, Almada, Portugal. raquelvifreitas@gmail.com.ORCID 0000-0001-5190-9191
Fátima GodinhoRheumatology Department, Hospital Garcia de Orta, Almada, Portugal.
Nathalie MadeiraInstituto Português Reumatologia, Lisboa, Portugal.
Bruno Miguel FernandesRheumatology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.
Flávio CostaRheumatology Department, Centro Hospitalar e Universitário Coimbra, Coimbra, Portugal.
Mariana SantiagoRheumatology Department, Centro Hospitalar e Universitário Coimbra, Coimbra, Portugal.
Agna NetoRheumatology Department, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Soraia AzevedoRheumatology Department, ULSAM, Ponte de Lima, Portugal.
Maura CoutoRheumatology Department, Hospital São Teotónio, Viseu, Portugal.
Graça SequeiraRheumatology Department, Hospital Faro, Faro, Portugal.
João Madruga DiasRheumatology Department, Centro Hospitalar Médio Tejo, Torres Novas, Portugal.
Miguel BernardesRheumatology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.
Luís MirandaInstituto Português Reumatologia, Lisboa, Portugal.
Joaquim Polido PereiraRheumatology Department, Centro Hospitalar e Universitário Santa Maria, Lisboa, Portugal.
João Eurico FonsecaRheumatology Department, Centro Hospitalar e Universitário Santa Maria, Lisboa, Portugal.
Maria José SantosRheumatology Department, Hospital Garcia de Orta, Almada, Portugal.
University of Lisbon · PTHospitais da Universidade de Coimbra · PTHospital Garcia de Orta · PTInstituto Português de Malacologia · PTCentro Hospitalar de Lisboa Ocidental · PTCentro Hospitalar do Porto · PTHospital de Faro EPE · PTHospital de São João · PTHospital São Teotónio · PTUniversidade do Porto · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe number of older patients with rheumatoid arthritis is increasing, but data on drug effectiveness and safety in these patients are scarce. This study assessed the effectiveness and safety of biologic disease-modifying antirheumatic drugs in older patients with rheumatoid arthritis.

methodsThis prospective cohort study was based on data recorded in the Rheumatic Diseases Portuguese Register (Reuma.pt). Treatment persistence, European League Against Rheumatism response at 6 and 12 months, and adverse events were compared between adult (age < 65 years), old (age 65-74 years), and very old (age ≥ 75 years) patients.

resultsIn total, 2401 patients were included, of which 379 were old and 83 were very old. Older patients had higher disease activity at baseline (Disease Activity Score 28: 5.5 in adults, 5.7 in old patients, and 6 in very old patients; p = 0.02) and more comorbidities, with patients aged 65-74 years beginning biologic disease-modifying antirheumatic drugs later in the course of rheumatoid arthritis. Treatment persistence was similar in the three patient groups (p = 0.07). The European League Against Rheumatism response rates were comparable in the three groups at 6 months (81.6% of adults, 75.2% of old patients, and 81.8% of very old patients; p = 0.19), and inferior in old patients at 12 months. The proportion of patients who experienced adverse events was also similar in the three groups (21% of adults, 22.5% of old patients, and 22.9% of very old patients; p = 0.76), but the rate of serious adverse events was higher in old patients (1.94/100 patient-years) and very old patients (4.29/100 patient-years) compared with 1.03/100 patient-years in adult patients with rheumatoid arthritis (p < 0.05).

conclusionsAdults, old patients, and very old patients with rheumatoid arthritis benefit similarly from biologic disease-modifying antirheumatic drug treatments, although older patients have more active disease at baseline and more comorbidities. However, it is necessary to consider the risk of serious adverse events in older patients when prescribing a biologic.

Indexed as

AdultAgedAge FactorsAntibodies, MonoclonalAntirheumatic AgentsArthritis, RheumatoidBiological ProductsCohort StudiesComorbidityFemaleHumansKaplan-Meier EstimateMaleMiddle AgedPortugalProspective StudiesAntibodies, MonoclonalAntirheumatic AgentsBiological Products

Identifiers

PMID33205322
OpenAlexW3099740868

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.