#2-71E. Optimizing RA Management in the Elderly: Balancing Efficacy and Comorbidity Risks (Autoimmun Rev, 2020)

Are you hesitant to pursue aggressive treat-to-target strategies for your elderly Rheumatoid Arthritis (RA) patients due to concerns over comorbidities and adverse events? This review, "Rheumatoid arthritis in the elderly: Characteristics and treatment considerations," addresses the unique challenges of managing the expanding population of elderly RA patients, which encompasses both elderly-onset and long-standing disease. Management is complicated by the need to balance robust treat-to-target goals against the high risk of adverse events associated with increased comorbidities and immunosenescence. The key finding is that the majority of RA therapies demonstrate comparable efficacy and safety in elderly patients, suggesting that age alone should not preclude aggressive treatment. This calls for a shift toward personalized medicine based on individual risk profiles. However, we must critically note that elderly patients are often underrepresented in clinical trials due to age restrictions and existing comorbidities, limiting the robustness of current evidence on optimal strategies. This paper is crucial for clinicians as it provides a tailored approach to managing complex elderly RA patients, aiding in drug selection, dose adjustment, and monitoring to maximize therapeutic benefit while mitigating risks associated with polypharmacy and geriatric syndromes.

Citation: Lina Serhal, May N. Lwin, Christopher Holroyd, Christopher J. Edwards. Rheumatoid arthritis in the elderly: Characteristics and treatment considerations. Autoimmunity Reviews. 2020. DOI: https://doi.org/10.1016/j.autrev.2020.102528

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