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老年和年轻强直性脊柱炎患者的生物治疗:TURKBIO真实世界数据结果

Biological treatment in elderly and young patients with ankylosing spondylitis: TURKBIO real-life data results.

作者信息

Uslu Sadettin, Gülle Semih, Urak Özkan, Şen Gerçek, Dalkılıç Ediz, Şenel Soner, Akar Servet, İnanç Nevsun, Cefle Ayşe, Köken Avşar Aydan, Yolbaş Servet, Yılmaz Sema, Soysal Gündüz Özgül, Sarı İsmail, Birlik Merih, Akkoç Nurullah, Önen Fatoş

机构信息

Department of Internal Medicine, Division of Rheumatology, Celal Bayar University Faculty of Medicine, Manisa, Türkiye.

Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye.

出版信息

Arch Rheumatol. 2024 Mar 20;39(2):232-241. doi: 10.46497/ArchRheumatol.2024.10391. eCollection 2024 Jun.

Abstract

OBJECTIVES

This study aims to investigate the effect of age on disease activity and biological treatment in patients with ankylosing spondylitis (AS).

PATIENTS AND METHODS

A total of 811 AS patients registered in the TURKBIO registry database between 2011 and 2019 were categorized according to their age at the time of entry into the registry and assigned to one of two groups: young patients, defined as <60 years of age (n=610), and those aged ≥60 years (n=201) were recorded as elderly patients. Demographic, clinical, and laboratory characteristics, along with disease activity markers and other follow-up parameters, as well as current and prior treatments, were electronically recorded during each visit using open-source software.

RESULTS

The mean age of the elderly patients was 67±5.8 years, while the mean age of the younger patients was 49.2±10.9 years. Male predominance was lower in the older AS group compared to the younger AS group (p=0.002). During follow-up period, 397 patients (comprising 318 young and 79 elderly individuals) had a history of using at least one biological disease-modifying agent (bDMARD). There was no significant difference between the groups in terms of DMARD and bDMARD-use distributions. First tumor necrosis factor inhibitor (TNFi) retention rates were found to be similar in both groups over 10 years of follow-up. Adverse events were found to be similar in young (19.9%) and elderly (26.8%) AS patients.

CONCLUSION

Research in the TURKBIO cohort reveals that both older and younger patients with AS exhibited similar disease activity levels with comparable treatment approaches. Moreover, the results of TNFi treatments in elderly patients were the same as those observed in younger patients, with no notable increase in safety concerns.

摘要

目的

本研究旨在调查年龄对强直性脊柱炎(AS)患者疾病活动度及生物治疗的影响。

患者与方法

2011年至2019年在TURKBIO注册数据库中登记的811例AS患者,根据其进入注册时的年龄进行分类,分为两组:年龄小于60岁的年轻患者(n = 610),年龄大于或等于60岁的患者(n = 201)记录为老年患者。每次就诊时使用开源软件电子记录人口统计学、临床和实验室特征,以及疾病活动标志物和其他随访参数,以及当前和既往治疗情况。

结果

老年患者的平均年龄为67±5.8岁,而年轻患者的平均年龄为49.2±10.9岁。与年轻AS组相比,老年AS组男性占比更低(p = 0.002)。在随访期间,397例患者(包括318例年轻患者和79例老年患者)有使用至少一种生物改善病情抗风湿药(bDMARD)的病史。两组在DMARD和bDMARD使用分布方面无显著差异。在10年的随访中,发现两组的首个肿瘤坏死因子抑制剂(TNFi)保留率相似。发现年轻(19.9%)和老年(26.8%)AS患者的不良事件相似。

结论

TURKBIO队列研究表明,老年和年轻AS患者的疾病活动水平相似,治疗方法相当。此外,老年患者TNFi治疗结果与年轻患者相同,安全性问题无明显增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a7a/11196228/dd18ce7184ef/AR-2024-39-2-232-241-F1.jpg

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