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[老年抗风湿药物治疗的安全性]

[Safety of antirheumatic drug treatment in the elderly].

作者信息

Krüger K, Strangfeld A, Kneitz C

机构信息

Rheumatologisches Praxiszentrum, St. Bonifatius Str. 5, 81541, München, Deutschland.

Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland.

出版信息

Z Rheumatol. 2014 Apr;73(3):244-50. doi: 10.1007/s00393-013-1245-3.

Abstract

Mainly due to the general demographic changes and decreasing mortality in rheumatic diseases based on therapeutic progress, the proportion of older patients treated by rheumatologists is growing. Drug treatment in the elderly, however, harbors certain risks including age-specific pharmacokinetic features and high rates of multimorbidity and polypharmacy resulting in a risk of drug interactions and adherence problems. Nevertheless, older patients suffering from rheumatic diseases ought to be treated with the same intensity and same targets as the younger counterparts. Bearing all these facts in mind it is a balancing act for rheumatologists to find an optimal treatment for the individual elderly patient. Fear of risks should not lead to hesitant use of drugs leaving these patients alone with treatment deficits, as some studies have suggested.

摘要

主要由于总体人口结构变化以及基于治疗进展风湿性疾病死亡率降低,风湿病学家治疗的老年患者比例正在增加。然而,老年人的药物治疗存在一定风险,包括特定年龄的药代动力学特征以及高比例的多种疾病共存和多种药物并用,这会导致药物相互作用风险和依从性问题。尽管如此,患有风湿性疾病的老年患者应该接受与年轻患者相同强度和相同目标的治疗。考虑到所有这些事实,对于风湿病学家来说,为个体老年患者找到最佳治疗方法是一项需要权衡的工作。正如一些研究所表明的,对风险的恐惧不应导致对药物的犹豫使用,从而使这些患者得不到充分治疗。

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