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Frequency of Biological Drug Use in Older Patients with Immune-Mediated Inflammatory Diseases: Results from the Large-Scale Italian VALORE Distributed Database Network

dc.rights.licenseopenen_US
dc.contributor.authorSOARDO, Federica
dc.contributor.authorSPINI, Andrea
dc.contributor.authorPELLEGRINI, Giorgia
dc.contributor.authorCOSTA, Giorgio
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorMATHIEU, Clement
dc.contributor.authorBELLITTO, Chiara
dc.contributor.authorL'ABBATE, Luca
dc.contributor.authorINGRASCIOTTA, Ylenia
dc.contributor.authorLEONI, Olivia
dc.contributor.authorZANFORLINI, Martina
dc.contributor.authorANCONA, Domenica
dc.contributor.authorSTELLA, Paolo
dc.contributor.authorCAVAZZANA, Anna
dc.contributor.authorSCAPIN, Angela
dc.contributor.authorLOPES, Sara
dc.contributor.authorBELLEUDI, Valeria
dc.contributor.authorLEDDA, Stefano
dc.contributor.authorCARTA, Paolo
dc.contributor.authorROSSI, Paola
dc.contributor.authorEJLLI, Lucian
dc.contributor.authorSAPIGNI, Ester
dc.contributor.authorPUCCINI, Aurora
dc.contributor.authorSCARPELLI, Rita Francesca
dc.contributor.authorDE SARRO, Giovambattista
dc.contributor.authorALLOTTA, Alessandra
dc.contributor.authorPOLLINA, Sebastiano Addario
dc.contributor.authorDA CAS, Roberto
dc.contributor.authorBUCANEVE, Giampaolo
dc.contributor.authorMANGANO, Antea Maria Pia
dc.contributor.authorBALDUCCI, Francesco
dc.contributor.authorSORRENTINO, Carla
dc.contributor.authorSENESI, Ilenia
dc.contributor.authorTUCCORI, Marco
dc.contributor.authorGINI, Rosa
dc.contributor.authorSPILA-ALEGIANI, Stefania
dc.contributor.authorMASSARI, Marco
dc.contributor.authorURRU, Silvana Anna Maria
dc.contributor.authorCAMPOMORI, Annalisa
dc.contributor.authorTRIFIRO, Gianluca
dc.date.accessioned2025-05-23T09:31:35Z
dc.date.available2025-05-23T09:31:35Z
dc.date.issued2025-04-03
dc.identifier.issn1179-190Xen_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206699
dc.description.abstractEnBACKGROUND: Limited real-world data on biological drug use in older patients with immune-mediated inflammatory diseases (IMIDs) exist despite these drugs carrying serious risks in this population. OBJECTIVE: We aimed to describe the frequency and persistence of biological drug use in older patients (≥ 65 years) with IMID, including inflammatory bowel diseases (IBDs), psoriatic arthritis/psoriasis, rheumatoid arthritis (RA), and ankylosing spondylitis, in a large Italian population. METHODS: A retrospective cohort study using the VALORE distributed claims database network from 13 Italian regions in the years 2010-2022 was performed. Older patients with IMID receiving biological drugs were included. Yearly prevalence of biological drug use and treatment persistence among incident users, from first dispensing to discontinuation/switching to another drug, was measured. Multivariable logistic regression was employed to identify treatment discontinuation predictors. RESULTS: The prevalence of biological drug use in older patients with IMID increased dramatically from 2010 (0.44 per 1000 residents) to 2022 (2.48 per 1000 residents). Overall, 25,284 incident users of biological drugs were identified, with a female/male ratio of 1.6 and a mean age of 71.0 (standard deviation ± 5.2) years. The median duration of follow-up was 4.2 (2.5-6.6) years, and the most common indication for use was RA (n = 8371; 33.1%). Overall, biological drug persistence was 54.4% at 1 year from treatment start. The highest persistence rates were found for vedolizumab and ustekinumab in patients with IBD (ulcerative colitis, 68.1% and 76.2%, respectively; Crohn's disease, 69.6% and 88.1%, respectively). Polypharmacy, advanced age, and female sex were identified as predictors of treatment discontinuation. CONCLUSIONS: This study documented a significant rise in biological drug use among older patients with IMID in Italy over the last decade. Around 50% of users discontinued treatment after the first year, with even higher rates observed in very old patients with polypharmacy. These findings highlight potential concerns about the use of biological therapies in older patients and underscore the urgent need for large-scale cohort studies to address the current knowledge gaps regarding their safety and effectiveness in this vulnerable population.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/us/*
dc.title.enFrequency of Biological Drug Use in Older Patients with Immune-Mediated Inflammatory Diseases: Results from the Large-Scale Italian VALORE Distributed Database Network
dc.title.alternativeBioDrugsen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s40259-025-00716-2en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed40180772en_US
bordeaux.journalBioDrugsen_US
bordeaux.page499-512en_US
bordeaux.volume39en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue3en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamAHEAD_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-05081617
hal.version1
hal.date.transferred2025-05-23T09:31:43Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BioDrugs&rft.date=2025-04-03&rft.volume=39&rft.issue=3&rft.spage=499-512&rft.epage=499-512&rft.eissn=1179-190X&rft.issn=1179-190X&rft.au=SOARDO,%20Federica&SPINI,%20Andrea&PELLEGRINI,%20Giorgia&COSTA,%20Giorgio&MATHIEU,%20Clement&rft.genre=article


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