Pharmacotherapy Pearls in Rheumatology for the Care of Older Adult Patients: Focus on Oral Disease-Modifying Antirheumatic Drugs and the Newest Small Molecule Inhibitors

Rheum Dis Clin North Am. 2018 Aug;44(3):371-391. doi: 10.1016/j.rdc.2018.03.010. Epub 2018 Jun 12.

Abstract

Providing safe and effective pharmacotherapy to geriatric patients with rheumatologic disorders is challenging. Multidisciplinary care involving rheumatologists, primary care physicians, and other specialties can optimize benefit and reduce adverse outcomes. Oral disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the small molecule inhibitors tofacitinib and apremilast have distinctive monitoring requirements and specific adverse reaction profiles. This article provides clinically relevant pearls for use of these interventions in older patients.

Keywords: Apremilast; DMARDs; Geriatrics; Rheumatoid arthritis; Rheumatology; Tofacitinib.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Aged
  • Antirheumatic Agents* / administration & dosage
  • Antirheumatic Agents* / adverse effects
  • Geriatrics / methods
  • Humans
  • Molecular Targeted Therapy / methods*
  • Rheumatic Diseases / drug therapy*
  • Rheumatology / methods
  • Rheumatology / trends

Substances

  • Antirheumatic Agents