Biological treatment in elderly and young patients with ankylosing spondylitis: TURKBIO real-life data results
Sadettin Uslu1
, Semih Gülle2, Özkan Urak2, Gerçek Şen2, Ediz Dalkılıç3, Soner Şenel4, Servet Akar5, Nevsun İnanç6, Ayşe Cefle7, Aydan Köken Avşar8, Servet Yolbaş9, Sema Yılmaz10, Özgül Soysal Gündüz1, İsmail Sarı2, Merih Birlik2, Nurullah Akkoç1, Fatoş Önen2
1Department of Internal Medicine, Division of Rheumatology, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
2Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye
3Department of Internal Medicine, Division of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Türkiye
4Department of Internal Medicine, Division of Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
5Department of Internal Medicine, Division of Rheumatology, Katip Çelebi University Faculty of Medicine, Izmir, Türkiye
6Department of Internal Medicine, Division of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Türkiye
7Department of Internal Medicine, Division of Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
8Department of Internal Medicine, Division of Rheumatology, Kocaeli City Hospital, Kocaeli, Türkiye
9Department of Internal Medicine, Division of Rheumatology, İnönü University Faculty of Medicine, Malatya, Türkiye
10Department of Internal Medicine, Division of Rheumatology, Selçuk University Faculty of Medicine, Konya, Türkiye
Keywords: Adverse event, ankylosing spondylitis, biological disease-modifying anti-rheumatic drug, geriatric, tumor necrosis factor inhibitor.
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.
Citation: Uslu S, Gülle S, Urak Ö, Şen G, Dalkılıç E, Şenel S, et al. Biological treatment in elderly and young patients with ankylosing spondylitis: TURKBIO real-life data results. Arch Rheumatol 2024;39(2):232-241. doi: 10.46497/ ArchRheumatol.2024.10391.
The TURKBIO database project has been approved as a phase IV observational study by the Turkish Ministry of Health Drug Regulatory Agency and also by the Gaziantep University Ethics Committee (date: 20.06.2013, no: 20.06.2013/253). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
All authors contributed to the literature search, analysis and/or interpretation, and design. The first draft of the manuscript was written by Sadettin Uslu and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
It is sponsored by the “Rheumatic Diseases Follow-up Association (ROHIDER)” in Izmir.
The data that support the findings of this study are available from the corresponding author upon reasonable request.