scholarly journals Micro-incision vitrectomy surgery for primary rhegmatogenous retinal detachments with posterior vitreous detachments in elderly patients: Preoperative characteristics and surgical outcomes

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244614
Author(s):  
Kazuya Yamashita ◽  
Saki Sakakura ◽  
Yoshiko Ofuji ◽  
Maho Sato ◽  
Takashi Nagamoto ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Outcomes ◽  
Posterior Vitreous Detachment ◽  
The Elderly ◽  
Young Group ◽  
Group Differences ◽  
Corrected Visual Acuity ◽  
Intraocular Pressure Elevation ◽  
Younger Patient ◽  
Vitrectomy Surgery

Purpose To assess the preoperative characteristics and surgical outcomes of using micro-incision vitrectomy surgery (MIVS) to treat RRD with posterior vitreous detachment (PVD) in an older and a younger patient group. Methods This retrospective cohort study included 407 eyes from 397 patients with primary RRD with PVD who were consecutively treated in our hospital from February 2016 to February 2020. PVD was diagnosed clinically by the presence of a Weiss ring, or was diagnosed morphologically via optical coherence tomography and subsequently confirmed during surgery. The main outcome measures were preoperative RRD characteristics, best-corrected visual acuity (BCVA), and postoperative complications. Results Data were analysed from 55 eyes in the elderly group (age 70 and older), and 352 eyes in the young group (age 69 and younger). There was no significant inter-group difference in the initial reattachment rate. Preoperative characteristics indicated that elderly patients had a significantly lower rate of phakic eyes, shorter mean axial length, lower lattice incidence, and longer time spans from onset to surgery. There were no significant between-group differences in the incidence of the following complications: fibrin formation, intraocular pressure elevation, epi-retinal membrane on the macula, intraocular lens optic capture, proliferative vitreoretinopathy, and vitreous haemorrhage. While the elderly patients had significant postoperative improvements in BCVA, these improvements were significantly lower than those of the younger patients. Conclusions This study highlighted the characteristics and surgical outcomes of MIVS in elderly patients with RRD. Although the time from onset to surgery was longer, MIVS still can be performed safely to improve older patients’ postoperative BCVA.

FRI0075 DECREASED RISKS OF HOSPITALIZED INFECTION UNDER TARGETED THERAPIES VS METHOTREXATE IN ELDERLY AND OLDER ELDERLY PATIENTS COMPARED TO YOUNGER PATIENTS WITH RHEUMATOID ARTHRITIS USING JAPANESE HEALTH INSURANCE DATABASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 614-615
Author(s):  
R. Sakai ◽  
E. Tanaka ◽  
M. Majima ◽  
M. Harigai
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Insurance ◽  
Elderly Patients ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Research Support ◽  
Chugai Pharmaceutical ◽  
Insurance Database ◽  
Icd10 Code

Background:Recently, vital prognosis has been improved in patients with rheumatoid arthritis (RA)1. In elderly patients, it is difficult to establish a treatment strategy due to multi-morbidities and treatment-related risks. Since older age is a significant risk factor of serious infections, one of the primary concerns during treatment of RA, rheumatologists should always strike a balance between efficacy and safety of the immunosuppressive treatment. However, infection data under the targeted therapy (TT) in elderly patients is still limited to date.Objectives:To compare the risk of hospitalized infection (HI) under the TT among young, elderly, and older elderly patients with RA using the Japanese health insurance database.Methods:This retrospective longitudinal population-based study was conducted using claims data in Japan provided by Medical Data Vision Co., Ltd. We defined individuals as RA cases if they met all of the following: 1) having at least one ICD10 code (M05x, M06x except for M061, or M08x except for M081 and M082); 2) having at least one prescription of disease-modifying antirheumatic drugs (DMARDs) including methotrexate (MTX) and TT (biological DMARDs and Janus kinase inhibitors) between April 2008 and September 2018; and 3) 16 years old or older. We define the month patients met the above all criteria for the first time in this database as the index month. We excluded patients who were prescribed any DMARDs during the first 12 months from MTX users and those with prescription of any TT during the first 12 months from TT users (i.e., prevalent users). Among the study population, we divided patients into 3 groups according to their age at the index month; young group (16-64), elderly group (65-74), and older elderly group (>=75). The observation started from the index month and ended at 36 months later, the last month of the exposure of DMARDs, the month of loss of follow-up, or September 2019, whichever came first. HI was defined by ICD10 code with one prescription of predefined drugs for each infection during hospitalizations. Some of HIs were defined by ICD10 code alone.Results:In this study, 8269, 6454, 5745 patients with RA were included in the young, elderly, and older elderly groups, respectively. The incidence rate (IR) of HI (/100 patient-years [PY]) [95%CI] was 3.4 [3.1-3.7] in the young group, 5.8 [5.3-6.3] in the elderly group, and 12.0 [11.2-12.8] in the older elderly group. IR rate (IRR) of HI (reference: the young group) was 1.7 [1.5-1.9] in the elderly group and 3.6 [3.2-4.0] in the older elderly group. In the young group, the IRR of HI in TT users vs MTX users was significantly elevated (1.8 [1.5-2.1]), whereas, those of the elderly and the older elderly groups were significantly decreased (IRR 0.8 [0.7-0.9] for elderly; 0.6 [0.5-0.7] for older elderly). Concomitant use of immunosuppressive DMARDs or prednisolone >=10mg/day with TT became less frequent with aging.Conclusion:The elderly and older elderly patients had significantly higher risks of HI compared to the young. The risk of HI under the TT compared to MTX was decreased in the elderly patients, probably due to adjusting for treatment by attending physicians.References:[1]Arthritis Rheum 2014;66:786-93Acknowledgments:This work was supported by JSPS KAKENHI Grant Number 17K08963.Disclosure of Interests:Ryoko Sakai Grant/research support from: Tokyo Women’s Medical University (TWMU) has received unrestricted research grants forDivision of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases from Ayumi Pharmaceutical Co. Ltd., Bristol Meyers Squib, Chugai Pharmaceutical Co. Ltd., Nippon Kayaku Co. Ltd., Taisho Toyama Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corp., and with which TWMU paid the salary of R.S., Eiichi Tanaka Consultant of: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Speakers bureau: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., masako majima: None declared, masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma.

scholarly journals Feasibility of balloon endoscope-assisted endoscopic retrograde cholangiopancreatography for the elderly

2020 ◽  
Vol 08 (09) ◽  
pp. E1202-E1211
Author(s):  
Ryunosuke Hakuta ◽  
Hirofumi Kogure ◽  
Yousuke Nakai ◽  
Tsuyoshi Hamada ◽  
Tatsuya Sato ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
The Elderly ◽  
Group Differences ◽  
Success Rates ◽  
Technical Success ◽  
Endoscopic Retrograde ◽  
Elderly Individuals ◽  
Technical Success Rate ◽  
Surgically Altered Anatomy

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered anatomy is challenging. Recently, balloon endoscopy has been shown to facilitate ERCP for this population with a high technical success rate, but adverse events (AEs) are not uncommon. Compared to non-elderly patients, elderly patients may be at higher risk of AEs due to underlying comorbidities. The current study aimed to evaluate the feasibility of balloon endoscope-assisted ERCP (BE-ERCP) for the elderly. Patients and methods We retrospectively identified patients who underwent BE-ERCP between January 2010 and September 2019. For patients who underwent multiple procedures during the study period, the first session was analyzed. Early AEs associated with BE-ERCP were compared between elderly (≥ 75 years) and non-elderly patients. Results A total of 1,363 BE-ERCP procedures were performed, and 568 patients (211 elderly and 357 non-elderly) were included for the analyses. Technical success rates were high in both the elderly and non-elderly groups (80 % vs. 80 %, respectively). The rates of early AEs were similar between the groups (12 % vs. 9.0 % in the elderly and non-elderly group, respectively; P = 0.31). The mltivariable-adjusted odds ratio for early AEs comparing elderly to non-elderly patients was 1.36 (95 % confidence interval, 0.74–2.51; P = 0.32). Specifically, we did not observe between-group differences in rates of gastrointestinal perforation (2.4 % vs. 2.8 % in elderly and non-elderly groups, respectively; P = 0.99) and aspiration pneumonia (1.9 % vs. 0.6 %, P = 0.20). Conclusions BE-ERCP is a feasible procedure for elderly individuals with surgically altered anatomy.

scholarly journals Differences in Preoperative Gastric Ultrasound Findings Between Old and Young Surgical Patients: A Retrospective Case-Control Study

2021 ◽  
Author(s):  
Jin Hee Ahn ◽  
Jae-Geum Shim ◽  
Sung Hyun Lee ◽  
Kyoung-Ho Ryu ◽  
Mi Yeon Lee ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Case Control Study ◽  
Young Patients ◽  
The Elderly ◽  
Young Group ◽  
Pulmonary Aspiration ◽  
Elderly Group ◽  
Retrospective Case ◽  
Cutoff Values ◽  
Control Study

Abstract Background: Most gastric ultrasound studies have been conducted in young middle-aged patients. Although age is known to influence gastric ultrasound, comparisons of gastric ultrasound in elderly patients with young patients have not been well elucidated. This study aimed to 1) compare gastric ultrasound assessments between young and elderly patients, 2) determine whether the CSA cutoff values for elderly and young patients should be different, and 3) suggest CSA cutoff values for elderly patients.Methods: This retrospective case-control study evaluated the data of 120 patients who underwent elective surgery under general anesthesia between July 2019 and August 2020. Demographic and gastric ultrasound assessment data were retrieved. Patients were divided into the elderly group (n = 58, age: ≥65 years) and young group (n = 62, age: <65 years). The antral cross-sectional area (CSA) in the supine and right lateral decubitus positions (RLDP), semiquantitative three-point Perlas grade (grades 0, 1, and 2), and gastric volume were determined. CSAs according to different Perlas grades were compared between the two groups. The CSA cutoff values for predicting a high risk of pulmonary aspiration in both the groups were determined. Results: Among patients with Perlas grade 0 (empty stomach), the CSA supine and CSA RLDP were greater in the elderly group than in the young group (CSA supine: 5.12 ± 1.99 cm2 vs. 3.92 ± 0.19 cm2, P = 0.002, and CSA RLDP: 6.24 ± 0.43 cm2 vs. 4.58 ± 0.21 cm2, P = 0.002). The specificity, positive predictive value, and accuracy of the CSA decreased when the CSA cutoff value for the young group (CSA RLDP: 6.92 cm2) was applied to the elderly group. The CSA cutoff values for the elderly group were: CSA supine, 6.92 cm2 and CSA RLDP, 10.65 cm2.Conclusions: The CSA of the empty stomach was greater in elderly patients than in young patients. The CSA cutoff values for predicting pulmonary aspiration risk in elderly and young patients should be differentiated. We suggest that the following CSA cutoff values should be used for predicting pulmonary aspiration risk in elderly patients: CSA supine, 6.92 cm2 and CSA RLDP, 10.65 cm2.

scholarly journals Efficacy, safety, and adherence of tocilizumab therapy in elderly patients with rheumatoid arthritis: A real-world observational study

2021 ◽  
Vol 19 ◽  
pp. 205873922110457
Author(s):  
Yoshinobu Nakao ◽  
Yu Funakubo Asanuma ◽  
Takuma Tsuzuki Wada ◽  
Mayumi Matsuda ◽  
Hiroaki Yazawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Survival Rate ◽  
Elderly Patients ◽  
Disease Activity ◽  
Activity Index ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Drug Survival ◽  
Significant Difference

Objective: We evaluated the efficacy, safety, and drug survival rate of tocilizumab in the elderly patients with rheumatoid arthritis (RA). Methods: This study was conducted in 108 RA patients who started tocilizumab between 2008 and 2018. The patients were divided into a young group (<65 years) and an elderly group (≥65 years). The efficacy, safety, and drug survival rate of tocilizumab were compared between the two groups. Results: At baseline, there were no significant differences between the elderly ( n = 45) and the young group ( n = 63) in RA duration, percentage of biologic-naïve, and RA disease activity. Health Assessment Questionnaire-Disability Index (HAQ-DI) was higher, renal function was worse, and frequency of using methotrexate was lower in the elderly group. Tocilizumab demonstrated similar efficacy in the elderly and the young group with Clinical Disease Activity Index and HAQ-DI. Compared with baseline, the frequency of steroid use was lower at one year after initiation of tocilizumab in both groups. There was no significant difference between the groups in the drug survival rate of tocilizumab for three years. Discontinuation rates of TCZ due to toxic adverse events were similar between the two groups. Conclusions: The efficacy, steroid-sparing effect, and safety of tocilizumab therapy, as well as the drug survival rate for three years, were not inferior in elderly RA compared to young RA patients.

scholarly journals Comparison of elderly and young patient populations treated with deep brain stimulation for Parkinson’s disease: long-term outcomes with up to 7 years of follow-up

2019 ◽  
Vol 131 (3) ◽  
pp. 807-812 ◽  
Author(s):  
Joshua A. Hanna ◽  
Tyler Scullen ◽  
Lora Kahn ◽  
Mansour Mathkour ◽  
Edna E. Gouveia ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Elderly Patients ◽  
Motor Function ◽  
The Elderly ◽  
Young Group ◽  
Long Term Outcomes ◽  
Deep Brain

OBJECTIVEDeep brain stimulation (DBS) is the procedure of choice for Parkinson’s disease (PD). It has been used in PD patients younger than 70 years because of better perceived intra- and postoperative outcomes than in patients 70 years or older. However, previous studies with limited follow-up have demonstrated benefits associated with the treatment of elderly patients. This study aims to evaluate the long-term outcomes in elderly PD patients treated with DBS in comparison with a younger population.METHODSPD patients treated with DBS at the authors’ institution from 2008 to 2014 were divided into 2 groups: 1) elderly patients, defined as having an age at surgery ≥ 70 years, and 2) young patients, defined as those < 70 years at surgery. Functional and medical treatment outcomes were evaluated using the Unified Parkinson’s Disease Rating Scale part III (UPDRS III), levodopa-equivalent daily dose (LEDD), number of daily doses, and number of anti-PD medications. Study outcomes were compared using univariate analyses, 1-sample paired t-tests, and 2-sample t-tests.RESULTSA total of 151 patients were studied, of whom 24.5% were ≥ 70 years. The most common preoperative Hoehn and Yahr stages for both groups were 2 and 3. On average, elderly patients had more comorbidities at the time of surgery than their younger counterparts (1 vs 0, p = 0.0001) as well as a higher average LEDD (891 mg vs 665 mg, p = 0.008). Both groups experienced significant decreases in LEDD following surgery (elderly 331.38 mg, p = 0.0001; and young 108.6 mg, p = 0.0439), with a more significant decrease seen in elderly patients (young 108.6 mg vs elderly 331.38 mg, p = 0.0153). Elderly patients also experienced more significant reductions in daily doses (young 0.65 vs elderly 3.567, p = 0.0344). Both groups experienced significant improvements in motor function determined by reductions in UPDRS III scores (elderly 16.29 vs young 12.85, p < 0.0001); however, reductions in motor score between groups were not significant. Improvement in motor function was present for a mean follow-up of 3.383 years postsurgery for the young group and 3.51 years for the elderly group. The average follow-up was 40.6 months in the young group and 42.2 months in the elderly group.CONCLUSIONSThis study found long-term improvements in motor function and medication requirements in both elderly and young PD patients treated with DBS. These outcomes suggest that DBS can be successfully used in PD patients ≥ 70 years. Further studies will expand on these findings.

Distribution of Hounsfield Unit Values in the Pelvic Bones: A Comparison Between Young and Elderly Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Naoya Inagaki ◽  
Takaaki Tanaka ◽  
Jun Udaka ◽  
Shoshi Akiyama ◽  
Tatsuki Matsuoka ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Young Patients ◽  
Hounsfield Unit ◽  
The Elderly ◽  
Young Group ◽  
Ischial Tuberosity ◽  
Elderly Group ◽  
Ct Scans ◽  
Pelvic Bone ◽  
Pubic Bone

Abstract Background The fixation strength of bone screws depends on bone mineral density (BMD), so it is important to evaluate bone strength at fracture sites. Few studies have investigated BMD in the pelvis. The aims of this study were to measure the regional Hounsfield unit (HU) values in the cancellous bone of the acetabulum and pelvic ring and to compare these values between young and elderly patients. Methods This study enrolled young patients with high-energy trauma (aged 20–44 years; young group) and elderly patients with low-energy trauma (aged 65–89 years; elderly group). Patients without pelvic computed tomography (CT) scans, those with pelvic bone implants, and those who died were excluded. The HU values on the contralateral (non-fractured) side of the pelvis were measured on CT scans. The CT data were divided into 7 areas: the pubic bone, the anterior and posterior walls and roof of the acetabulum, the ischial tuberosity, the body of the ilium, and the third lumbar vertebra. The HU values in each area were compared between the young and elderly groups. Results Sixty-one young patients and 154 elderly patients were included in the study. The highest HU value was in the roof of the acetabulum regardless of age and sex. HU values were significantly higher in the ischial tuberosity and body of the ilium and lower in the pubic bone and anterior wall. The HU values in all pelvic areas were significantly lower in the elderly group than in the young group, especially in the anterior area. Conclusions HU values in the 6 pelvic areas were not uniform and were strongly related to load distribution. The HU distribution and age-related differences could explain the characteristic causes and patterns of acetabular fractures in the elderly and may help in surgical treatment.

scholarly journals Laparoscopic Cholecystectomy in the Elderly: An Experience at a Tertiary Care Hospital in Western Nepal

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tika Ram Bhandari ◽  
Sudha Shahi ◽  
Rajeev Bhandari ◽  
Rajesh Poudel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Medical Records ◽  
Elderly Population ◽  
Tertiary Care ◽  
Young Patients ◽  
The Elderly ◽  
Young Group ◽  
Perioperative Outcomes ◽  
Care Hospital

Background. The incidence of gallstone increases with increasing age. No studies have been reported in the elderly population with laparoscopic cholecystectomy from developing nations. The aim of this study was to compare perioperative outcomes of laparoscopic cholecystectomy between the elderly (≥60 years old) and the young (<60 years old).Methods. From July 2015 to June 2016, a retrospective review of medical records of 78 elderly patients (≥60 years old) and 164 young patients (<60 years old) who underwent laparoscopic cholecystectomy was done. The patients’ demographics and perioperative outcomes were analyzed.Results. Median ages were 65 years (range: 60–80) and 45 years (range: 21–59) for the elderly group and the young group. The majority of patients were female (62.8 and 72%). There were no significant differences in the conversion rate (9 and 7.9%,P=0.78), postoperative complications (17.9 and 14.6%,P=0.50), and length of stay in the hospital (4 days for both groups,P=0.35) between the two groups. There was no mortality in either of the groups.Conclusion. Our results of laparoscopic cholecystectomy in elderly patients are comparable with those in young patients. Therefore, laparoscopic cholecystectomy is safe even in the elderly population.

scholarly journals Colorectal Cancer Treatment and Follow-Up in the Elderly: An Inexplicably Different Approach

2012 ◽  
Vol 97 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Giovanni Li Destri ◽  
Mario Cavallaro ◽  
Maria Antonietta Trovato ◽  
Francesca Ferlito ◽  
Marine Castaing ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Cancer Treatment ◽  
Complementary Therapies ◽  
Malignant Tumors ◽  
The Elderly ◽  
Neoplastic Disease ◽  
Younger Patient ◽  
Colorectal Cancer Treatment

Abstract The incidence of colorectal cancer increases as age progresses. At present, elderly patients have received substandard cancer treatment not supported by “evidence.” Geriatric assessment should be performed preoperatively and selected elderly patients must be offered standard surgical treatment receiving the same complementary therapies as a younger patient. It should be stressed that elderly patients should not be deprived of their decision-making role. In our experience, more than 43% of patients with colorectal cancer are ≥70 years of age, and we believe that they should receive the same type of follow-up. This would allow for the detection and removal of polyps, treatment of malignant tumors, and psychological support similarly to younger patients. Significantly, in our experience, the incidence of reoperation for neoplastic disease is similar in the two patient populations.

SAT0116 COMPARISON OF THE EFFICACY OF ABATACEPT ON ELDERLY AND YOUNG PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 992.1-992
Author(s):  
S. Muraoka ◽  
Z. Yamada ◽  
W. Hirose ◽  
H. Kono ◽  
S. Yasuda ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Disease Activity ◽  
Young Patients ◽  
The Elderly ◽  
Young Group ◽  
Response Criteria ◽  
Eular Response ◽  
Steroid Use ◽  
Chugai Pharmaceutical ◽  
Significant Difference

Background:The widespread use of biologic agents has greatly improved the prognosis of rheumatoid arthritis (RA). On the other hand, elderly patients with RA are relatively increasing. Although achieving low disease activity is a goal for those elderly patients as well as young patients, the efficacy of tumor necrosis factor inhibitors were reported to be equally or slightly less effective in elderly patients than in young patients. There is a lack of evidence for the efficacy of abatacept (ABT) in elderly patients.Objectives:In this study, we aimed to clarify the efficacy of ABT in elderly and young patients with RA compared to csDMARDs.Methods:This is a multicenter, open-label, prospective, observational study. All patients with RA enrolled this study are refractory to csDMARDs and have not received any biologics. Either ABT or csDMARDs was administered at the discretion of physicians to elderly (65 years and older) and young (20-64 years) patients (ABT-elderly, ABT-young, control (CTL)-elderly, and CTL-young groups). Comparison was made between 4 groups of patients. The primary study endpoint was a good response by EULAR response criteria at week 24 after administration. The research procedure has been approved by the ethics committee of Toho University School of Medicine (Approval number: A17112).Results:A total of 219 patients, 127 in the ABT group and 92 in the CTL group, were enrolled in this study. The majority of patients were women (82.7%) with a mean age (±SD) of 64.9±13.6 years (74.5±5.9 years in the elderly group and 52.4±10.1 years in the young group). The ABT group had higher disease activity, higher HAQ, and higher steroid use rates and dosage than the CTL group. These were also observed in the elderly group. In the young group, although the ABT group had higher disease activity and higher HAQ than the CTL group, no difference was observed in steroid use rates and dosage. The ABT group more frequently achieved a good response by EULAR response criteria compared to the CTL group at week 24 (58.8% and 27.2%, respectively, p<0.0001). The ABT group also showed higher efficacy than the CTL group in the elderly and young groups with a good response. Regarding the improvement in DAS28-ESR and DAS28-CRP, the ABT group was also superior to the CTL group. There was no difference on efficacy between elderly and young patients from the ABT groups.Based on propensity score matching for disease activity at baseline, 61 matched pairs of patients treated with ABT or csDMARDs were statistically extracted. Although there was no significant difference in the rate of patients with a good response by EULAR response criteria between the ABT and the CTL groups, the ABT group showed significantly better response than the CTL group in the elderly. Furthermore, the ABT group was superior to the CTL group in improvement in both DAS28-ESR and DAS28-CRP, and similar results were obtained in the elderly. However, there was no significant difference between the ABT group and the CTL group in the young. In addition, elderly patients had significant improvement in DAS28-ESR compared with young patients in the ABT group.Conclusion:Treatment with ABT showed higher efficacy compared with CTL, particularly in elderly patients with RA.References:[1]Harigai M, et al. Mod Rheumatol. 2019;29:747.[2]Sugihara T, Harigai M. Drugs Aging. 2016;33:97.Disclosure of Interests:Sei Muraoka Consultant of: Asahikasei Pharma Corp., Speakers bureau: Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd., Asahikasei Pharma Corp., and Astellas Pharma Inc., Zento Yamada: None declared, Wataru Hirose: None declared, Hajime Kono: None declared, Shinsuke Yasuda Speakers bureau: Bristol Myers Squibb, Chugai Pharmaceutical Co., Tanabe Mitsubishi Parma Co., and GlaxoSmith Kline, Toshihiro Nanki Grant/research support from: Chugai Pharmaceutical Co., Eisai Co., Ltd., Teijin Pharma Ltd., Eli Lilly Japan K.K., Bristol-Myers K.K., Ono Pharmaceutical Co., Ltd., Novartis Pharma K.K., Asahikasei Pharma Corp., Mitsubishi-Tanabe Pharma Co., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Pfizer Japan Inc., Daiichi Sankyo Co., Ltd., Shionogi & Co., Ltd., Sanofi K.K., Nippon Kayaku Co., Ltd., Yutoku Pharmaceutical Ind. Co., Ltd., UCB Japan Co. Ltd., Nihon Pharmaceutical Co., Ltd., and Bayer Yakuhin, Ltd., Consultant of: UCB Japan Co., Ltd., Eisai Co., Ltd., and Chugai Pharmaceutical Co., Speakers bureau: Mitsubishi-Tanabe Pharma Co., Chugai Pharmaceutical Co., Eisai Co., Ltd., Astellas Pharma Inc., Janssen Pharmaceutical K.K., Ayumi Pharmaceutical Co., Pfizer Japan Inc., Asahikasei Pharma Corp., Sanofi K.K., Novartis Pharma K.K., Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., Teijin Pharma Ltd., Takeda Pharmaceutical Co., Nippon Boehringer Ingelheim Co., Ltd., and AbbVie GK.

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