nach oben

Tipp

Antirheumatic drugs in older adults and polypharmacy issues

Zeitschrift:: Zeitschrift für Gerontologie und Geriatrie

Autoren:: MD Ilke Coskun Benlidayi, MD Yesim Gokce Kutsal

Abstract

Older individuals experience various noninflammatory and autoimmune inflammatory rheumatic diseases. Given the increased incidence of rheumatic conditions in older adults, it is of great importance for healthcare providers to be aware of the potential benefits and risks of antirheumatic drugs. The present article aims to provide a comprehensive review regarding antirheumatic drug use in older patients, particularly by focusing on safety issues and polypharmacy. Antirheumatic medications include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids and disease-modifying antirheumatic drugs (DMARDs), which comprise conventional synthetic DMARDs, targeted synthetic DMARDs and biological DMARDs. Due to the alteration in drug pharmacokinetics and pharmacodynamics in old people, antirheumatic drug efficiency and safety may be different than in the younger population. Polypharmacy and multimorbidity are other potential challenges to be faced during the treatment of older patients with rheumatic diseases. The current review also discusses the strategies to minimize adverse reactions due to antirheumatic drugs.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Jetzt einloggen Kostenlos registrieren

Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:

Zeitschrift für Gerontologie und Geriatrie

Print-Titel

• Themenbezogene Hefte behandeln Fragen der Gerontologie, der Biologie und Grundlagenforschung des Alterns und der geriatrischen Forschung

• Erweitert mit Beiträgen zu Therapie, Psychologie und Soziologie sowie der praktischen Altenpflege.

• Hot topics von Experten knapp, aussagekräftig und provokativ kommentiert

Jetzt informieren

Akter R, Maksymowych WP, Martin ML, Hogan DB (2020) Outcomes with biological disease-modifying anti-rheumatic drugs (bDMARDs) in older patients treated for rheumatoid arthritis. Can Geriatr J 23(2):184–189. https://doi.org/10.5770/cgj.23.393 CrossRefPubMedPubMedCentral

Alpay-Kanitez N, Pehlivan Ö, Omma A et al (2020) Favorable retention rates and safety of conventional anti-rheumatic drugs in older patients with rheumatoid arthritis. Medicine 99(16):e19696. https://doi.org/10.1097/MD.0000000000019696 CrossRefPubMedPubMedCentral

Bechman K, Subesinghe S, Norton S, Atzeni F, Galli M, Cope AP, Winthrop KL, Galloway JB (2019) A systematic review and meta-analysis of infection risk with small molecule JAK inhibitors in rheumatoid arthritis. Baillieres Clin Rheumatol 58(10):1755–1766. https://doi.org/10.1093/rheumatology/kez087 CrossRef

Bechman K, Clarke BD, Rutherford AI et al (2019) Polypharmacy is associated with treatment response and serious adverse events: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Baillieres Clin Rheumatol 58(10):1767–1776. https://doi.org/10.1093/rheumatology/kez037 CrossRef

Betancourt BY, Biehl A, Katz JD, Ananta Subedi A (2018) Pharmacotherapy pearls in rheumatology for the care of older adult patients: focus on oral disease-modifying antirheumatic drugs and the newest small molecule inhibitors. Rheum Dis Clin North Am 44(3):371–391. https://doi.org/10.1016/j.rdc.2018.03.010 CrossRefPubMedPubMedCentral

2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019) American Geriatrics Society 2019 updated AGS beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc 67(4):674–694. https://doi.org/10.1111/jgs.15767 CrossRef

Conklin J, Farrell B, Suleman S (2019) Implementing deprescribing guidelines into frontline practice: barriers and facilitators. Res Social Adm Pharm 15(6):796–800. https://doi.org/10.1016/j.sapharm.2018.08.012 CrossRefPubMed

Coskun Benlidayı I (2019) Polypharmacy in geriatric rheumatology. Rheumatol Int 39:1115–1116. https://doi.org/10.1007/s00296-019-04264-1 CrossRefPubMed

Coskun Benlidayi I (2020) The effectiveness and safety of electrotherapy in the management of fibromyalgia. Rheumatol Int 40(10):1571–1580. https://doi.org/10.1007/s00296-020-04618-0 CrossRefPubMed

10.

Curtis JR, Schulze-Koops H, Takiya L et al (2017) Efficacy and safety of tofacitinib in older and younger patients with rheumatoid arthritis. Clin Exp Rheumatol 35(3):390–400 PubMed

11.

Dalal DS, Duran J, Brar T et al (2019) Efficacy and safety of biological agents in the older rheumatoid arthritis patients compared to young: a systematic review and meta-analysis. Semin Arthritis Rheum 48(5):799–807. https://doi.org/10.1016/j.semarthrit.2018.07.009 CrossRefPubMed

12.

Day AL, Singh JA (2019) Cardiovascular disease risk in older adults and elderly patients with rheumatoid arthritis: what role can disease-modifying antirheumatic drugs play in cardiovascular risk reduction? Drugs Aging 36(6):493–510. https://doi.org/10.1007/s40266-019-00653-0 CrossRefPubMed

13.

Ebina K, Hashimoto M, Yamamoto W et al (2019) Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis—The ANSWER cohort study. PLoS ONE 14(5):e216624. https://doi.org/10.1371/journal.pone.0216624 CrossRefPubMedPubMedCentral

14.

Eyigor S, Gokce Kutsal Y (2012) Polypharmacy in the elderly: to prescribe or not prescribe “that is the question”. Turk J Geriatr 15(4):445–454

15.

Farrell B, Richardson L, Raman-Wilms L, de Launay D, Alsabbagh MW, Conklin J (2018) Self-efficacy for deprescribing: a survey for health care professionals using evidence-based deprescribing guidelines. Res Social Adm Pharm 14(1):18–25. https://doi.org/10.1016/j.sapharm.2017.01.003 CrossRefPubMed

16.

Gokce Kutsal Y, Barak A, Atalay A et al (2009) Polypharmacy in the elderly: a multicenter study. J Am Med Dir Assoc 10(7):486–490. https://doi.org/10.1016/j.jamda.2009.03.018 CrossRefPubMed

17.

Hanly JG, Lethbridge L (2020) Disease modifying anti-rheumatic drugs, biologics and corticosteroid use in older patients with rheumatoid arthritis over 20 years. J Rheumatol. https://doi.org/10.3899/jrheum.200310 CrossRefPubMed

18.

Herrinton LJ, Liu L, Chen L et al (2012) Association between anti-TNF‑α therapy and all-cause mortality. Pharmacoepidemiol Drug Saf 21(12):1311–1320. https://doi.org/10.1002/pds.3354 CrossRefPubMedPubMedCentral

19.

Juby A, Davis P (2011) An evaluation of the impact of seniors on a rheumatology referral clinic: demographics and pharmacotherapy. Clin Rheumatol 30(11):1507–1509. https://doi.org/10.1007/s10067-011-1845-8 CrossRefPubMed

20.

Kivitz AJ, Cohen S, Keystone EA et al (2018) A pooled analysis of the safety of tofacitinib as monotherapy or in combination with background conventional synthetic disease-modifying antirheumatic drugs in a Phase 3 rheumatoid arthritis population. Semin Arthritis Rheum 48(3):406–415. https://doi.org/10.1016/j.semarthrit.2018.07.006 CrossRefPubMed

21.

Kolasinski SL, Neogi T, Hochberg MC et al (2020) 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol 72(2):220–233. https://doi.org/10.1002/art.41142 CrossRefPubMed

22.

Lahaye C, Tatar Z, Dubost JJ, Tournadre A, Soubrier M (2019) Management of inflammatory rheumatic conditions in the elderly. Rheumatology 58(5):748–764. https://doi.org/10.1093/rheumatology/key165 CrossRefPubMed

23.

Leon L, Gomez A, Vadillo C et al (2018) Severe adverse drug reactions to biological disease-modifying anti-rheumatic drugs in elderly patients with rheumatoid arthritis in clinical practice. Clin Exp Rheumatol 36(1):29–35 PubMed

24.

Massalska M, Maslinski W, Ciechomska M (2020) Small molecule inhibitors in the treatment of rheumatoid arthritis and beyond: latest updates and potential strategy for fighting COVID-19. Cells 9(8):1876–1811. https://doi.org/10.3390/cells9081876 CrossRefPubMedCentral

25.

Ozen G, Pedro S, England BR, Mehta B, Wolfe F, Michaud K (2019) Risk of serious infection in patients with rheumatoid arthritis treated with biologic versus nonbiologic disease-modifying antirheumatic drugs. ACR Open Rheumatol 1(7):424–432. https://doi.org/10.1002/acr2.11064 CrossRefPubMedPubMedCentral

26.

Pilotto A, Franceschi M, Leandro G, Di Mario F, Geriatric Gastroenterology Study Group (Societè Italiana Gerontologie Geriatria) (2003) NSAID and aspirin use by the elderly in general practice: effect on gastrointestinal symptoms and therapies. Drugs Aging 20(9):701–710. https://doi.org/10.2165/00002512-200320090-00006 CrossRefPubMed

27.

Rajasimhan S, Pamuk O, Katz JD (2020) Safety of Janus kinase inhibitors in older patients: a focus on the thromboembolic risk. Drugs Aging 37(8):551–558. https://doi.org/10.1007/s40266-020-00775-w CrossRefPubMedPubMedCentral

28.

Richter MD, Matteson EL, Davis JM 3rd, Achenbach SJ, Crowson CS (2019) Comparison of biologic discontinuation in patients with elderly-onset versus younger-onset rheumatoid arthritis. ACR Open Rheumatol 1(10):627–631. https://doi.org/10.1002/acr2.11083 CrossRefPubMedPubMedCentral

29.

Sood A, Raji MA (2020) Cognitive impairment in elderly patients with rheumatic disease and the effect of disease-modifying anti-rheumatic drugs. Clin Rheumatol. https://doi.org/10.1007/s10067-020-05372-1 CrossRefPubMed

30.

Sugihara T, Harigai M (2016) Targeting low disease activity in elderly-onset rheumatoid arthritis: current and future roles of biological disease-modifying antirheumatic drugs. Drugs Aging 33(2):97–107. https://doi.org/10.1007/s40266-015-0341-2 CrossRefPubMedPubMedCentral

31.

Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K (2015) Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol 71(12):1415–1427. https://doi.org/10.1007/s00228-015-1954-4 CrossRefPubMed

32.

Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J (2018) A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis 9(1):143–150. https://doi.org/10.14336/AD.2017.0306 CrossRefPubMedPubMedCentral

Titel: Antirheumatic drugs in older adults and polypharmacy issues
Autoren:: MD Ilke Coskun Benlidayi
MD Yesim Gokce Kutsal
Publikationsdatum: 10.06.2021
DOI: https://doi.org/10.1007/s00391-021-01907-6
Verlag: Springer Medizin
Zeitschrift: Zeitschrift für Gerontologie und Geriatrie
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269