Fleischmann R, Baumgartner S W, Weisman M H, Liu T, White B, Peloso P
University of Texas Southwestern Medical Center at Dallas, 5939 Harry Hines Boulevard, Dallas, Texas 75235, USA.
Ann Rheum Dis. 2006 Mar;65(3):379-84. doi: 10.1136/ard.2005.035287. Epub 2005 Sep 8.
To determine the long term safety profile of the tumour necrosis factor (TNF) antagonist etanercept in subjects with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) aged > or =65 years in comparison with subjects aged <65 years.
Safety data from an integrated database of 4322 subjects enrolled in 18 RA trials, 2 PsA trials, and 2 AS trials were analysed. Safety end points included subject incidence of all adverse events (AE), serious adverse events (SAE), infectious events (IE), medically important infections (MII), and deaths. Events of particular interest in subjects treated with TNF modulating biological treatments, including demyelinating diseases, tuberculosis, lymphomas, and cardiovascular diseases, were also evaluated.
The incidence of AE, SAE, IE, MII, and malignancies was not significantly raised in elderly subjects in comparison with subjects aged <65 years. No cases of tuberculosis were reported in the trials. Demyelinating diseases were seen only in subjects aged <65 years. The incidence and types of death in the elderly subjects were consistent with the expected rates for subjects of comparable age.
Etanercept is a generally safe and well tolerated biological agent for treatment of rheumatological diseases in the elderly, and the risk of AE in these studies was no greater in subjects aged > or =65 years than in younger subjects.
比较年龄≥65岁的类风湿关节炎(RA)、银屑病关节炎(PsA)或强直性脊柱炎(AS)患者与年龄<65岁的患者使用肿瘤坏死因子(TNF)拮抗剂依那西普的长期安全性。
分析了来自18项RA试验、2项PsA试验和2项AS试验的4322名受试者综合数据库的安全性数据。安全性终点包括所有不良事件(AE)、严重不良事件(SAE)、感染事件(IE)、具有重要医学意义的感染(MII)和死亡的受试者发生率。还评估了接受TNF调节生物治疗的受试者特别关注的事件,包括脱髓鞘疾病、结核病、淋巴瘤和心血管疾病。
与年龄<65岁的受试者相比,老年受试者中AE、SAE、IE、MII和恶性肿瘤的发生率没有显著升高。试验中未报告结核病病例。脱髓鞘疾病仅在年龄<65岁的受试者中出现。老年受试者的死亡率和死亡类型与同龄受试者的预期发生率一致。
依那西普是一种用于治疗老年风湿性疾病的总体安全且耐受性良好的生物制剂,在这些研究中,年龄≥65岁的受试者发生AE的风险并不高于年轻受试者。