Tumour @entity39 factor-alpha antagonists in the management of XXXX in the elderly: a review of their efficacy and safety.

@entity1 @entity66 @entity39 @entity5 @entity310 @entity158 @entity309
@entity309 ( @entity309 ) is a chronic inflammatory disease that frequently affects @entity1 aged >or=65 years, causing significant impairment with @entity158 . Elderly @entity309 @entity1 have specific problems, including co-morbid diseases, numerous concomitant medications, greater number of damaged joints as a result of @entity66 and often a more severe disease presentation in elderly-onset @entity309 . These factors, together with an age-related decline in the immune defence mechanisms, make elderly @entity1 more vulnerable. The new era of biologic medications has made intensive treatment of @entity309 patients possible. Anti- @entity5 @entity39 factor-alpha (anti- @entity310 ) agents can cause a dramatic improvement in disease activity and functional capacity, making complete remission of @entity309 a possible target. @entity310 has been shown to play an important role in both the healthy aging process and age-related diseases such as @entity309 . Targeting this cytokine in elderly @entity1 is therefore reasonable. However, it is not clear whether treatment effects can be reached to the same extent in both elderly and younger @entity1 and whether anti- @entity310 treatment specifically increases the risk of certain adverse events in elderly @entity309 @entity1 . This review discusses the currently available evidence relating to the efficacy and safety of anti- @entity310 medication in @entity309 @entity1 aged >or=65 years treated in clinical trials and observational studies. Despite a slightly less robust effect in elderly patients, anti- @entity310 treatment has a similar long-term efficacy in @entity1 aged >or=65 years and @entity1 aged <65 years. The majority of the study results showed that anti- @entity310 treatment does not elevate the risk of infections beyond the risk found in age-matched controls. When a moderate increase in risk was found, this occurred equally in elderly and younger @entity1 . Furthermore, whereas anti- @entity310 agents were found to be relatively safe in the treatment of elderly @entity309 @entity1 , treatment with corticosteroids significantly elevated the risk of serious infections. Corticosteroids are frequently used in elderly @entity1 , but the evidence suggests that preference should increasingly be given to anti- @entity310 agents, for which the expected benefits will mostly outweigh the modestly increased risks of associated adverse events.
