Antirheumatic Drug Treatment in Elderly Patients

作者：Krueger K^*

来源：Aktuelle Rheumatologie, 2009, 34(5): 286-290.

DOI：10.1055/s-0029-1237358

• drug treatment
• antirheumatic drugs
• elderly patients

Factors like multimorbidity, multimedication, frequent impairment of renal function and pharmacokinetic differences make drug treatment in elderly patients a challenge. Nevertheless satisfactory treatment of the elderly RA patient is possible in most cases because of the many different treatment possibilities existing today. Unfortunately nearly all controlled studies exclude geriatric patients, and studiies targeting this population are rare which means drug treatment in the elderly is rather empirical than evidence-based. Basically the "go low go slow" principle is recommended for drug use in geriatric patients. Among the frequently applied antirheumatic drugs, the use of glucorticoids, hydroxychloroquine and sulphasalazine and leflunomide is rather uncomplicated whereas the DMARD "gold standard" methotrexate can be used only in patients without signs of renal insufficiency. In highly active disease, biologicals are effective also in geriatric RA patients but a higher rate of infectious complications in this age group has to be kept in mind.

• 出版日期2009-10