Drug Survival on First Biologic Therapy Among Late‐Onset Rheumatoid Arthritis Patients Compared to Early‐Onset Patients: A Population‐Based Cohort Study

Abstract

ABSTRACTIntroductionRheumatoid arthritis (RA) patients can be divided according to the age of disease onset and classified as late‐onset RA ≥ 60 years old or early‐onset RA < 60 years old. Current treatment guidelines do not stipulate any preference regarding the biologic that should be used first in the late‐onset group. This study aims to compare the drug survival times on first biological treatment between late and early‐onset RA patients.MethodsThis is a population based cohort study using the medical records of Leumit healthcare services. We included all eligible RA patients between 2000 and 2017. RA patients were divided into late‐ and early‐onset RA groups and compared according to drug survival time on the first biological therapy.ResultsThe final cohort included 3814 RA patients, 2807 (73.6%) of whom had early‐onset RA. Overall, biologic disease‐modifying anti‐rheumatic drugs (bDMARDs) were used more often among early‐onset compared to late‐onset patients (16.9% vs. 7.8%, p < 0.001). Among early‐onset patients, etanercept was associated with the longest drug survival time on the first biologic, and adalimumab and infliximab were associated with the longest drug survival times among late‐onset patients. No differences were observed in drug survival times between late and early‐onset patients on the first bDMARD, except for abatacept and golimumab with longer drug survival time among early‐onset patients.ConclusionLate‐onset RA patients were treated with biologics to a lesser extent than early‐onset patients, but no differences were observed in drug survival times at the first bDMARD between the two groups.