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I’m 67 And Have Rheumatoid Arthritis… Can I Take Enbrel Safely?

By: Nathan Wei

Concerns regarding the relative safety of TNF inhibiting drugs has somewhat limited their use in older patients with rheumatoid arthritis (RA). The perception has been that older patients are more likely to have side-effects. These potential side effects include an increased rate of infection, increased problems related to bone marrow or liver toxicity, the development of a multiple-sclerosis like syndrome, and reactivation of tuberculosis.

A recent study though has provided data indicating that most patients aged 65 years or more with rheumatoid arthritis (RA) appear to tolerate anti-tumor necrosis factor (anti-TNF) therapy well.

Data from 1571 RA patients who had received at least 1 dose of anti-TNF agents over a 10-year period were evaluated by Swiss researchers.

Of this group, 344 were aged 65 years or more at the time of initial treatment. A comparison was made of discontinuation rates between this group and younger patients. Discontinuation of a therapy is done for two reasons: lack of effect or toxicity. The median time to discontinuation was about 3 years in both groups.

There also were no differences in the mean change in Disease Activity in 28 Joints ratings at 2 years. This measurement, called the Disease Activity Scale, is a quick and easy measurement of the amount of active rheumatoid arthritis a patient has at any given time.

However, Health Assessment Questionnaire (HAQ) scores improved significantly less in elderly patients. This was essentially due to lower scores in those aged more than 75 years. Health Assessments in older patients are generally worse than younger patients. This is because of the multiple health problems patients have as they get older.

The conclusion made by the researchers is that age in itself should not interfere with the decision to treat elderly patients with RA with anti-TNF agents. (Gabay C, et al. Arthritis Rheum 2007; 57:679-685).

This study should allay fears of using anti-TNF drugs in older patients. Nonetheless it’s important to realize that older patients often have other co-morbid conditions (ie., other medical problems) and are taking multiple medications.

Article Source: http://ezine-articles-planet.com

Nathan Wei MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine.For more info: Arthritis Treatment

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