Trends of disease activity in Japanese patients over 75 years with rheumatoid arthritis from 2014 to 2021- the ANSWER cohort study

医学 内科学 类风湿性关节炎 逻辑回归 队列 队列研究 疾病 多元分析 观察研究 回顾性队列研究
作者
H. Yamada,Sadao Jinno,Toshihisa Maeda,Shinya Hayashi,Wataru Yamamoto,Akira Ōnishi,Hideo Onizawa,Tohru Takeuchi,Yuji Hiramatsu,Yasutaka Okita,Kosuke Ebina,Yonsu Son,N. Yoshida,Ryu Watanabe,Ryota Hara,Masakazu Yamashita,Yoko Nose,Yuzuru Yamamoto,T. Okano,Keisuke Nishimura,Yoshimichi Ueda,Sho Sendo,Motomu Hashimoto,Ryosuke Kuroda,Jun Saegusa
出处
期刊:Rheumatology [Oxford University Press]
被引量:1
标识
DOI:10.1093/rheumatology/kead539
摘要

Abstract Objectives To investigate if disease activity among elderly RA patients >75 years of age has changed over time in the real-world clinical setting. Methods Data from an observational multicentre registry of RA patients in Japan were analysed. The primary outcome was to evaluate the changes in the proportion of very elderly RA patients (>75 years) who achieved remission and low disease activity (LDA), from 2014 to 2021. The secondary outcome was to identify factors associated with remission and LDA by comparing demographic and clinical characteristics among the patients who had a study visit within the study period, using multivariate logistic regression. Results A total of 32 161 patient visits were identified from 2014 to 2021. The proportion of patients >75 years of age increased from 16.5% to 26.9%, with biologics and targeted synthetic DMARDs (b/tsDMARDs) use increasing and glucocorticoids use decreasing, while conventional synthetic DMARDs use remained relatively stable. The proportion of RA patients >75 years of age achieving remission and LDA significantly increased from 62.2% to 78.2% (P for trend < 0.001). A negative factor associated with achieving remission and LDA was glucocorticoid use, seropositivity and a history of previous b/tsDMARDs use while MTX use was associated positively, independent of other predictors. Conclusions In our cohort, disease activity among very elderly RA patients has improved over time. The study suggests the importance of using a treat-to-target approach in very elderly RA patients to improve clinical outcomes.
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