Support for TNF inhibitor–methotrexate combination in older RA patients
medwireNews: Rheumatoid arthritis (RA) patients aged 65 years or older experience a similar response to treatment with golimumab plus methotrexate compared with younger patients, suggests a post-hoc analysis of the GO-FURTHER trial.
As reported in Arthritis Research & Therapy, ACR20 response rates were significantly higher among participants randomly assigned to receive the tumor necrosis factor (TNF) inhibitor (2 mg/kg intravenously at weeks 0 and 4, and every 8 weeks thereafter) plus methotrexate compared with those given placebo plus methotrexate, regardless of patient age.
Specifically, for the 77 participants aged 65 years and older, ACR20 response rates in the golimumab and placebo groups were 69.5% and 33.3%, respectively, and the corresponding rates for the 515 patients aged less than 65 years were 61.6% versus 31.3%.
John Tesser (Arizona Arthritis and Rheumatology Associates, Phoenix, USA) and colleagues note that, overall, the adverse event profile observed among older patients was “similar to the known safety profile of [intravenous] golimumab,” but there was a numerically higher incidence of serious infections among older patients. For example, at the 52-week follow-up, serious infection rates were 5.3% versus 1.4% for those aged at least versus less than 65 years, and 10.0% versus 1.7% for those aged at least versus less than 75 years.
The investigators caution that “the results of this post hoc analysis are based on small patient numbers,” particularly among the oldest participants, with just 10 people aged 75 years or above taking part in the study.
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