Evidence map›Paper›PMID 40789975›Full record

ArticleClinical rheumatology2025

Age-related disparities in biologic therapy initiation among rheumatoid arthritis patients: Insights from a large retrospective cohort study.

Sanjot Sunner, Britney Jones, C Allyson Jones, Yazid N Al Hamarneh, Cheryl Sadowski, Walter P Maksymowych, Elaine A Yacyshyn

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Sanjot SunnerFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Britney JonesFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
C Allyson JonesFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Yazid N Al HamarnehFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Cheryl SadowskiFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Walter P MaksymowychFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada.
Elaine A YacyshynFaculty of Medicine & Dentistry, University of Alberta, MacKenzie Health Sciences Center, 2J2.00 Walter C, Edmonton, AB, T6G2R7, Canada. eyacyshyn@ualberta.ca.ORCID http://orcid.org/0000-0002-2753-2790

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRheumatoid arthritis (RA) is a chronic inflammatory condition with increasing prevalence, particularly in older adults. This study examined differences in prescribing patterns of biologic DMARDs (bDMARDs) between younger (< 65 years) and older (≥ 65 years) adults and explored factors influencing delays in therapy initiation.

methodsA retrospective comparison of bDMARD use in younger (< 65 years) and older (≥ 65 years) adults who have RA was conducted using data from the Rheumatoid Arthritis Pharmacovigilance Program and Outcomes Research in Therapeutics (RAPPORT) registry. Disease activity was assessed using the Disease Activity Score (DAS28) and Health Assessment Questionnaire (HAQ). multivariable regression analysis was performed to explore factors associated with delayed bDMARD prescription.

resultsAmong 3411 patients, older adults experienced significantly longer delays in bDMARD initiation compared to younger patients (p < 0.0001). Older adults also demonstrated higher disease activity (HAQ: 1.75 vs. 1.48, DAS28: 5.95 vs. 5.49, both p < 0.0001) and elevated inflammatory markers. Regression analysis revealed that advanced age, comorbidity burden, smoking, and seropositivity were associated with delays in bDMARD initiation.

conclusionDespite evidence supporting bDMARD efficacy and safety, older RA patients face significant delays in therapy, leading to suboptimal disease control and increased adverse outcomes. Addressing age-related barriers to RA treatment is critical to improving equitable access. Further research is needed to investigate mechanisms underlying these disparities and assess the benefits of timely bDMARD initiation on long-term outcomes in older adults. Key Points • Older adults with rheumatoid arthritis experience significant delays in biologic therapy initiation compared to younger patients. • Addressing age-related treatment disparities is crucial for improving disease outcomes and quality of life. • Future research should investigate clinician hesitancy and patient barriers to timely biologic therapy initiation.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidBiological ProductsBiological TherapyHealthcare DisparitiesAdultAgedAge FactorsFemaleHumansMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexAntirheumatic AgentsBiological ProductsBiologic therapyDisease modifying antirheumatic drugsOlder adultsRheumatoid arthritisTreatment disparities

Identifiers

PMID40789975

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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.