Rheumatoid Arthritis Clinical Trial
Official title:
Safety and Effectiveness of Biological DMARDs in Elderly Patients With Rheumatoid Arthritis
Study objectives
1. Comparison of drug persistency rates between elderly RA patients and young RA patients
with biological DMARDs
2. Analysis of discontinuation reasons & influencing factors of drug discontinuation in
elderly RA patients and young RA patients
3. Comparison of the occurrence of adverse events & treatment outcomes between elderly RA
patients and young RA patients
1. Retrospective study:
We will collect data of Korean patients with RA retrospectively. Subjects will be
extracted from medical records of RA patients who had treated with TNF inhibitor or are
currently using TNF inhibitor. Patients who have received or are receiving biologic
agents including infliximab, etanercept, adalimumab, rituximab from Dec.2000 to
Dec.2010 will be enrolled.
Data for this study which are sex, date of birth, previous and current medication, the
results of laboratory test, disease activity of RA (DAS28ESR), comorbidity will be
collected. Information of treatment, DAS28ESR, laboratory data and SAEs will be
collected at baseline and predefined time points of follow-up (0, 3 month and recent
follow-up data).
During the first year of starting our study, we will focus to evaluate tolerability,
the reason of discontinuation in elderly RA patients through this retrospective study.
Tolerance could be analyzed by examining drug persistency of biologic DMARDs with the
reason that led to drug interruption, and the drug persistency curves will be compared
in the two groups. The length of time that patients remain on the drug therapy
represents a useful measure of the treatment effectiveness and tolerability. The reason
of discontinuation will be evaluate as descriptive analysis. And factors influenced on
drug discontinuation in elderly RA patients and young RA patients using
Cox-proportional analysis.
2. Prospectively study:
We will use the data of patients of Hanyang University Hospital for Rheumatic Diseases in
web-based registry of RA patients with biologic DMARDs. Patients who start on receiving
biologic agents including infliximab, etanercept, adalimumab, rituximab, abatacept will be
enrolled. At registration, sex, date of birth, previous and current medication, the results
of laboratory test, disease activity of RA (DAS28ESR), HAQ, comorbidity, socioeconomic
status, etc. will be collected. Information of treatment, DAS28ESR, HAQ, laboratory data and
SAEs, etc. will be collected at baseline and predefined time points of follow-up (0, 3 month
and every 6 month). This prospective study will be progressed during three years.
We will focus the response of biologic DMARDs and the occurrence of adverse event in elderly
RA patients in this prospective study. The response could be evaluated with the change of
DAS28ESR and functional disability (HAQ). We will compare the response in elderly RA
patients versus young RA patients, and evaluate the impact of old age on the response using
multiple logistic regression model with adjust various confounding factors. The occurrence
of adverse events during three years will be described in two groups
;
Observational Model: Cohort, Time Perspective: Prospective
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