Effectiveness of early introduction of certolizumab pegol in the treatment of elderly onset rheumatoid arthritis

Abstract

  Background: Elderly onset rheumatoid arthritis（EORA）often develops with high disease activity. Comorbidities are associated with intolerance to the treatment. Certolizumab pegol（CZP）for early RA patients was shown to be effective in C-OPERA study, but the evidence in elderly patients is limited. We aimed to investigate the effectiveness of early induction of CZP in EORA.

  Methods: We retrospectively analyzed the data obtained from consecutive 14 EORA patients who started treatment with CZP within 3 months after the induction of conventional synthetic disease modifying anti-rheumatic drugs.

  Results: Disease duration of RA at the time of induction of CZP was 3（2-4）months. The duration from introduction of csDMARDs was 17.5（13.3-23.0）days. Interstitial pneumonia was accompanied in 2 patient, chronic kidney disease in 5 patients and diabetes mellitus in 6 patients. After 4 weeks of treatment with CZP, DAS28-ESR（5.5（4.9-6.3）vs. 3.4（2.5-4.1）, p=0.001）and HAQ-DI（1.3（0.7-2.0）vs. 0.1（0-0.7）, p=0.001）were significantly improved. No infection occurred during the observational period. Within 24 weeks, 2 patients stopped using CZP because of secondary failure.

  Conclusion: Early introduction of CZP was effective in ameliorating disease activity and activity of daily life among elderly patients.