Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis?: An analysis of the British Society for Rheumatology Biologics Register

British Society for Rheumatology Biologics Register; Katie Bechman; Anuoluwapo Oke; Mark Yates; Sam Norton; Elaine Dennison; Andrew P. Cope; James B. Galloway

doi:10.1093/rheumatology/kez671

Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register

British Society for Rheumatology Biologics Register, Katie Bechman, Anuoluwapo Oke, Mark Yates, Sam Norton, Elaine Dennison, Andrew P. Cope, James B. Galloway

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To evaluate drug survival with monotherapy compared with combination therapy with MTX in RA older adults.

Methods: Patients from the British Society for Rheumatology Biologics Register, a prospective observational cohort, who were biologic naïve and commencing their first TNF inhibitors (TNFi) were included. The cohort was stratified according to age:
Results: The analysis included 15 700 patients. Ninety-five percent were
Conclusion: TNFi monotherapy is associated with increased treatment failure. In older adults, the disadvantage of TNFi monotherapy on drug survival is no longer seen. Patients ≥75 have fewer discontinuations due to inefficacy than adverse events compared with younger patients. This likely reflects greater disposition to toxicity but perhaps also a decline in immunogenicity associated with immunosenescence.

Original language	English
Pages (from-to)	2563–2571
Number of pages	9
Journal	Rheumatology
Volume	59
Issue number	9
Early online date	30 Jan 2020
DOIs	https://doi.org/10.1093/rheumatology/kez671
Publication status	Published - Sept 2020
Externally published	Yes

Keywords

rheumatoid arthritis
biologics
anti-TNF therapy
methotrexate
epidemiology

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10.1093/rheumatology/kez671

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British Society for Rheumatology Biologics Register, Bechman, K., Oke, A., Yates, M., Norton, S., Dennison, E., Cope, A. P., & Galloway, J. B. (2020). Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register . Rheumatology, 59(9), 2563–2571. https://doi.org/10.1093/rheumatology/kez671

@article{1ec693460a6446ba93a72401b2171a63,

title = "Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis?: An analysis of the British Society for Rheumatology Biologics Register ",

abstract = "Objective: To evaluate drug survival with monotherapy compared with combination therapy with MTX in RA older adults.Methods: Patients from the British Society for Rheumatology Biologics Register, a prospective observational cohort, who were biologic na{\"i}ve and commencing their first TNF inhibitors (TNFi) were included. The cohort was stratified according to age: Results: The analysis included 15 700 patients. Ninety-five percent were Conclusion: TNFi monotherapy is associated with increased treatment failure. In older adults, the disadvantage of TNFi monotherapy on drug survival is no longer seen. Patients ≥75 have fewer discontinuations due to inefficacy than adverse events compared with younger patients. This likely reflects greater disposition to toxicity but perhaps also a decline in immunogenicity associated with immunosenescence.",

keywords = "rheumatoid arthritis, biologics, anti-TNF therapy, methotrexate, epidemiology",

author = "{British Society for Rheumatology Biologics Register} and Katie Bechman and Anuoluwapo Oke and Mark Yates and Sam Norton and Elaine Dennison and Cope, {Andrew P.} and Galloway, {James B.}",

year = "2020",

month = sep,

doi = "10.1093/rheumatology/kez671",

language = "English",

volume = "59",

pages = "2563–2571",

journal = "Rheumatology",

issn = "1462-0332",

publisher = "Oxford University Press",

number = "9",

}

British Society for Rheumatology Biologics Register, Bechman, K, Oke, A, Yates, M, Norton, S, Dennison, E, Cope, AP & Galloway, JB 2020, 'Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register ', Rheumatology, vol. 59, no. 9, pp. 2563–2571. https://doi.org/10.1093/rheumatology/kez671

Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register . / British Society for Rheumatology Biologics Register; Bechman, Katie; Oke, Anuoluwapo et al.
In: Rheumatology, Vol. 59, No. 9, 09.2020, p. 2563–2571.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis?

T2 - An analysis of the British Society for Rheumatology Biologics Register

AU - British Society for Rheumatology Biologics Register

AU - Bechman, Katie

AU - Oke, Anuoluwapo

AU - Yates, Mark

AU - Norton, Sam

AU - Dennison, Elaine

AU - Cope, Andrew P.

AU - Galloway, James B.

PY - 2020/9

Y1 - 2020/9

N2 - Objective: To evaluate drug survival with monotherapy compared with combination therapy with MTX in RA older adults.Methods: Patients from the British Society for Rheumatology Biologics Register, a prospective observational cohort, who were biologic naïve and commencing their first TNF inhibitors (TNFi) were included. The cohort was stratified according to age: Results: The analysis included 15 700 patients. Ninety-five percent were Conclusion: TNFi monotherapy is associated with increased treatment failure. In older adults, the disadvantage of TNFi monotherapy on drug survival is no longer seen. Patients ≥75 have fewer discontinuations due to inefficacy than adverse events compared with younger patients. This likely reflects greater disposition to toxicity but perhaps also a decline in immunogenicity associated with immunosenescence.

AB - Objective: To evaluate drug survival with monotherapy compared with combination therapy with MTX in RA older adults.Methods: Patients from the British Society for Rheumatology Biologics Register, a prospective observational cohort, who were biologic naïve and commencing their first TNF inhibitors (TNFi) were included. The cohort was stratified according to age: Results: The analysis included 15 700 patients. Ninety-five percent were Conclusion: TNFi monotherapy is associated with increased treatment failure. In older adults, the disadvantage of TNFi monotherapy on drug survival is no longer seen. Patients ≥75 have fewer discontinuations due to inefficacy than adverse events compared with younger patients. This likely reflects greater disposition to toxicity but perhaps also a decline in immunogenicity associated with immunosenescence.

KW - rheumatoid arthritis

KW - biologics

KW - anti-TNF therapy

KW - methotrexate

KW - epidemiology

U2 - 10.1093/rheumatology/kez671

DO - 10.1093/rheumatology/kez671

M3 - Article

SN - 1462-0332

VL - 59

SP - 2563

EP - 2571

JO - Rheumatology

JF - Rheumatology

IS - 9

ER -

British Society for Rheumatology Biologics Register, Bechman K, Oke A, Yates M, Norton S, Dennison E et al. Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register . Rheumatology. 2020 Sept;59(9):2563–2571. Epub 2020 Jan 30. doi: 10.1093/rheumatology/kez671

Is background methotrexate advantageous in extending TNF inhibitor drug survival in elderly patients with rheumatoid arthritis? An analysis of the British Society for Rheumatology Biologics Register

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