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Systematic review: Safety and efficacy of anti-TNF in elderly patients
Revisión sistemática: eficacia y seguridad del tratamiento anti-TNF en pacientes ancianos
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We performed a systematic search in MEDLINE (Pubmed), EMBASE (Ovid), and the Cochrane Library Plus. Abstracts published in the American and European rheumatology congresses and articles in Reumatología Clínica were also reviewed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ten studies fulfilled the inclusion criteria. Studies show a similar efficacy in elderly and younger patients. The differences between the young and the elderly regarding DAS28 reductions before and after are very small: 0.04 in the Geneway et al study and 0.0 in the Mariette et al study, as well as in the before and after HAQ: 0.04 (Geneway et al), 0.18 (Schiff et al) and 0.06 (Mariette et al).Adverse events reported in elderly and younger patients are 83.3% and 77.1% respectively with etanercept, as reported by Fleischmann; 27.2% vs 12.5%, P=.19, as reported by Chevillotte, and the rate of withdrawal due to an adverse event was 57,8% vs 29,2% with infliximab, P=.03, 36% vs 15% P=.06 with adalimumab and 10,3% and 9,5%, with no significant P value, as reported by Massara.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The information to assess the efficacy and safety of anti-TNF therapy in elderly patients was obtained in all cases from sub analyses and therefore bias is possible. We can say, with a low to moderate level of evidence, that elderly patients undergoing anti-TNF treatments have a higher number of adverse events, and similar efficacy, when compared with younger patients.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar si la seguridad y la eficacia de los tratamientos anti TNF en pacientes ancianos con enfermedades reumáticas inflamatorias son similares a la seguridad y eficacia en pacientes jóvenes.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Revisión sistemática. Se realizó una búsqueda bibliográfica en Medline (vía Pubmed), Embase (vía Ovid) y Cochrane Library Plus, abstracts publicados en los congresos americano y europeo de reumatología y artículos publicados en Reumatología Clínica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Diez estudios cumplían los criterios de inclusión. Los estudios coinciden en una eficacia similar en jóvenes y ancianos. Las diferencias en la reducción del DAS28 de antes y después entre jóvenes y ancianos son muy pequeñas: 0,04 en el estudio de Geneway et al y 0,0 en el de Mariette et al; así como en el HAQ de antes y después: 0,04 (Geneway et al), 0,18 (Schiff et al) y 0,06 (Mariette et al).</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los efectos adversos descritos en ancianos y jóvenes respectivamente son de 83,3% y 77,1% con etanercept, según Fleischmann; 27,2% vs. 12,5%, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,19, según Chevillotte; y 57,8% vs. 29,2% con infliximab, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,03, 36% vs. 15%, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,01 con adalimumab y de 10,3% vs. 9,5% con etanercept, p no significativa, según Massara.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La información para evaluar la eficacia y seguridad de los anti TNF en ancianos procede de subanálisis y por tanto se encuentra sujeta a sesgos. Podemos decir, con un nivel de evidencia bajo o moderado, que los ancianos presentan más acontecimientos adversos y similar eficacia que en los no ancianos cuando se tratan con agentes anti TNF.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and prevalence of rheumatoid arthritis, based on the 1987 American College of Rheumatology criteria: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Alamanos" 1 => "P.V. Voulgari" 2 => "A.A. Drosos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semarthrit.2006.08.006" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 15 | 27 |
| 2024 October | 22 | 39 | 61 |
| 2024 September | 25 | 20 | 45 |
| 2024 August | 34 | 32 | 66 |
| 2024 July | 28 | 37 | 65 |
| 2024 June | 38 | 28 | 66 |
| 2024 May | 33 | 36 | 69 |
| 2024 April | 31 | 22 | 53 |
| 2024 March | 41 | 35 | 76 |
| 2024 February | 27 | 21 | 48 |
| 2024 January | 25 | 27 | 52 |
| 2023 December | 13 | 29 | 42 |
| 2023 November | 30 | 26 | 56 |
| 2023 October | 30 | 34 | 64 |
| 2023 September | 34 | 41 | 75 |
| 2023 August | 24 | 14 | 38 |
| 2023 July | 20 | 27 | 47 |
| 2023 June | 18 | 20 | 38 |
| 2023 May | 26 | 14 | 40 |
| 2023 April | 14 | 13 | 27 |
| 2023 March | 31 | 26 | 57 |
| 2023 February | 22 | 27 | 49 |
| 2023 January | 23 | 24 | 47 |
| 2022 December | 19 | 33 | 52 |
| 2022 November | 28 | 23 | 51 |
| 2022 October | 27 | 37 | 64 |
| 2022 September | 24 | 29 | 53 |
| 2022 August | 19 | 54 | 73 |
| 2022 July | 27 | 35 | 62 |
| 2022 June | 30 | 30 | 60 |
| 2022 May | 38 | 57 | 95 |
| 2022 April | 34 | 43 | 77 |
| 2022 March | 26 | 71 | 97 |
| 2022 February | 30 | 38 | 68 |
| 2022 January | 38 | 39 | 77 |
| 2021 December | 24 | 51 | 75 |
| 2021 November | 28 | 43 | 71 |
| 2021 October | 41 | 54 | 95 |
| 2021 September | 33 | 39 | 72 |
| 2021 August | 26 | 41 | 67 |
| 2021 July | 18 | 44 | 62 |
| 2021 June | 32 | 56 | 88 |
| 2021 May | 31 | 46 | 77 |
| 2021 April | 55 | 97 | 152 |
| 2021 March | 48 | 24 | 72 |
| 2021 February | 30 | 32 | 62 |
| 2021 January | 24 | 21 | 45 |
| 2020 December | 44 | 24 | 68 |
| 2020 November | 23 | 15 | 38 |
| 2020 October | 10 | 14 | 24 |
| 2020 September | 46 | 16 | 62 |
| 2020 August | 19 | 24 | 43 |
| 2020 July | 14 | 10 | 24 |
| 2020 June | 26 | 15 | 41 |
| 2020 May | 15 | 13 | 28 |
| 2020 April | 26 | 10 | 36 |
| 2020 March | 11 | 10 | 21 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 3 | 0 | 3 |
| 2019 September | 6 | 0 | 6 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 December | 2 | 0 | 2 |
| 2018 May | 5 | 1 | 6 |
| 2018 April | 17 | 6 | 23 |
| 2018 March | 22 | 15 | 37 |
| 2018 February | 11 | 5 | 16 |
| 2018 January | 12 | 4 | 16 |
| 2017 December | 13 | 7 | 20 |
| 2017 November | 16 | 5 | 21 |
| 2017 October | 17 | 7 | 24 |
| 2017 September | 12 | 9 | 21 |
| 2017 August | 11 | 7 | 18 |
| 2017 July | 8 | 10 | 18 |
| 2017 June | 25 | 9 | 34 |
| 2017 May | 42 | 9 | 51 |
| 2017 April | 34 | 4 | 38 |
| 2017 March | 26 | 17 | 43 |
| 2017 February | 9 | 1 | 10 |
| 2017 January | 19 | 5 | 24 |
| 2016 December | 42 | 10 | 52 |
| 2016 November | 30 | 6 | 36 |
| 2016 October | 33 | 6 | 39 |
| 2016 September | 32 | 12 | 44 |
| 2016 August | 25 | 3 | 28 |
| 2016 July | 17 | 6 | 23 |
| 2016 June | 2 | 12 | 14 |
| 2016 May | 2 | 7 | 9 |
| 2016 April | 1 | 0 | 1 |
| 2016 February | 0 | 8 | 8 |
| 2015 December | 4 | 0 | 4 |
| 2015 October | 4 | 0 | 4 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 1 | 11 | 12 |
| 2015 July | 22 | 5 | 27 |
| 2015 June | 24 | 13 | 37 |
| 2015 May | 42 | 18 | 60 |
| 2015 April | 27 | 23 | 50 |
| 2015 March | 24 | 25 | 49 |
| 2015 February | 31 | 15 | 46 |
| 2015 January | 20 | 27 | 47 |
| 2014 December | 16 | 15 | 31 |
| 2014 November | 17 | 27 | 44 |
| 2014 October | 19 | 17 | 36 |
| 2014 September | 17 | 21 | 38 |
| 2014 August | 19 | 21 | 40 |
| 2014 July | 20 | 25 | 45 |
| 2014 June | 33 | 16 | 49 |
| 2014 May | 42 | 22 | 64 |
| 2014 April | 35 | 13 | 48 |
| 2014 March | 43 | 17 | 60 |
| 2014 February | 25 | 15 | 40 |
| 2014 January | 28 | 21 | 49 |
| 2013 December | 29 | 11 | 40 |
| 2013 November | 18 | 9 | 27 |
| 2013 October | 34 | 12 | 46 |
| 2013 September | 32 | 16 | 48 |
| 2013 August | 28 | 22 | 50 |
| 2013 July | 25 | 19 | 44 |
| 2013 June | 25 | 23 | 48 |
| 2013 May | 23 | 20 | 43 |
| 2013 April | 25 | 22 | 47 |
| 2013 March | 18 | 28 | 46 |
| 2013 February | 14 | 17 | 31 |
| 2013 January | 18 | 9 | 27 |
| 2012 December | 20 | 10 | 30 |
| 2012 November | 11 | 12 | 23 |
| 2012 October | 5 | 7 | 12 |
| 2012 September | 8 | 2 | 10 |
| 2012 July | 1 | 0 | 1 |
| 2012 June | 4 | 0 | 4 |
| 2012 May | 1 | 0 | 1 |
| 2012 April | 5 | 0 | 5 |
| 2012 March | 4 | 0 | 4 |
| 2012 February | 5 | 0 | 5 |
| 2012 January | 4 | 0 | 4 |
| 2011 December | 2 | 0 | 2 |
| 2011 November | 6 | 0 | 6 |
| 2011 October | 3 | 0 | 3 |
| 2011 September | 2 | 0 | 2 |
| 2011 August | 4 | 0 | 4 |
| 2011 July | 2 | 0 | 2 |
| 2011 June | 4 | 0 | 4 |
| 2011 May | 3 | 0 | 3 |
| 2011 April | 14 | 0 | 14 |
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