Volume 20, Issue 3 pp. 346-352
Original Article

Risk factors of adverse events during treatment in elderly patients with rheumatoid arthritis: an observational study

Nozomi Iwanaga

Nozomi Iwanaga

Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan

Deparment of Rheumatology, Nagasaki Medical Center, Kubara Omura-city, Japan

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Kazuhiko Arima

Kazuhiko Arima

Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Kaoru Terada

Kaoru Terada

Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan

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Yukitaka Ueki

Yukitaka Ueki

Department of Rheumatology, Sasebo Chuo Hospital, Sasebo-city, Japan

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Yoshiro Horai

Yoshiro Horai

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Takahisa Suzuki

Takahisa Suzuki

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Yoshikazu Nakashima

Yoshikazu Nakashima

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Shin-ya Kawashiri

Shin-ya Kawashiri

Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Kunihiro Ichinose

Kunihiro Ichinose

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Mami Tamai

Mami Tamai

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Hideki Nakamura

Hideki Nakamura

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Kiyoshi Aoyagi

Kiyoshi Aoyagi

Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Atsushi Kawakami

Atsushi Kawakami

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

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Tomoki Origuchi

Corresponding Author

Tomoki Origuchi

Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

Department of Rehabilitation Sciences;, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki-city, Japan

Correspondence: Tomoki Origuchi, MD, Department of Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University 1–7-1 Sakamoto, Nagasaki-city 852–8520, Japan.

Email: [email protected]

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First published: 10 April 2014
Citations: 17

Abstract

Objectives

The risk factors of adverse events during a number of currently used treatments for rheumatoid arthritis (RA) in elderly patients were examined.

Methods

A retrospective observational study was conducted for 300 elderly RA patients registered in December 2009 at Sasebo Chuo Hospital, Japan, and the adverse events during the treatments for RA were assessed.

Results

The average age of the patients was 74.3 ± 5.8 years. The Steinbrocker stage was IV in almost one-half of the patients. Methotrexate (MTX) was used in 54.0% of patients and biologics in 23.0% of patients. Adverse events occurred in 103 patients (34.3%). The most common adverse events were infections (46.6%), including pneumonia (21.4%). Multiple logistic analyses revealed that the factors significantly related to infection were advanced Steinbrocker stage and the existence of respiratory diseases, and that of pneumonia was the existence of diabetes mellitus (DM).

Conclusions

The elderly RA patients with advanced stage, respiratory diseases or DM should be monitored for infections, including pneumonia, carefully during treatment.

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