Disease-modifying agents and immunosuppressive drugs in the elderly.

Disease-modifying and immunosuppressive therapies are required for elderly patients with rheumatic disorders. The evidence to date suggests that the criteria for choosing a particular drug is not vastly different from the choice in younger patients, and that the elderly have a similar response. More care is required in monitoring elderly patients on immunosuppressive drugs because of the potential for increased adverse reactions consequent on reduced functional capacity of major end organs. There is little data available to judge relative efficacy of these drugs in the elderly and with the 'greying' of the population these data should be sought after. With careful individual choice of drug and regular reassessment for effect and adverse drug reactions, many elderly patients with rheumatic diseases can obtain useful benefit from these agents.