Drugs & Aging最新文献

{"title":"Switching from Originator Tocilizumab to Biosimilar in Giant Cell Arteritis: Evaluation of Effectiveness and Safety in a Multicenter Cohort of 38 Patients.","authors":"Javier Loricera, Juan Molina-Collada, Juan Carlos Nieto, Marina Sánchez-Lucas, María Teresa Silva-Díaz, Patricia Moya, Eztizen Labrador, Iván Ferraz-Amaro, Ricardo Blanco","doi":"10.1007/s40266-026-01281-1","DOIUrl":"10.1007/s40266-026-01281-1","url":null,"abstract":"<p><strong>Background: </strong>Tocilizumab (TCZ) is an interleukin-6 receptor inhibitor approved for the treatment of giant cell arteritis (GCA). Biosimilars of TCZ, such as TYENNE™, are biologic agents which are similar to the originator (RoACTEMRA™) in structure, efficacy, and safety. Many indications, including GCA, are extrapolated from pivotal trials in rheumatoid arthritis (RA), supported by pharmacological similarity and immunogenicity data.</p><p><strong>Objective: </strong>The objective was to evaluate the effectiveness and safety of switching from originator TCZ (RoACTEMRA™) to biosimilar TCZ (TYENNE™) in patients with GCA managed in routine clinical practice.</p><p><strong>Methods: </strong>This observational, retrospective, multicenter, real-world study included patients with GCA who switched from RoACTEMRA™ to TYENNE™. Outcomes assessed included clinical and laboratory parameters of disease activity, complete remission, glucocorticoid burden, and safety profile. Comparisons were performed at baseline, 3 months, and 6 months. Linear mixed models and mixed-effects logistic regression were used to assess differences across follow-up visits.</p><p><strong>Results: </strong>A total of 38 patients (68.4% female; mean age 74.1 years) were included. GCA phenotypes comprised cranial (n = 14; 36.8%), extracranial (n = 14; 36.8%), and mixed presentation (n = 10; 26.3%). Prior exposure to RoACTEMRA™ averaged 36.3 ± 28.4 months. Subcutaneous TCZ was administered in 32 patients (84.2%), while 6 received intravenous therapy. At the time of switch, 92.1% were clinically asymptomatic and 81.6% met criteria for complete remission. TYENNE™ was used as monotherapy in 34 patients (89.5%) and in combination with methotrexate in 4 patients (10.5%). Treatment regimens were preserved in all but one patient who was receiving originator TCZ at a dose of 4 mg/kg every 6 weeks, in whom the dosing interval was spaced from 6 to 8 weeks. After a mean follow-up of 8.2 ± 3.1 months, no significant differences were found in complete remission rates, daily prednisone dose, or inflammatory markers respect to baseline. Retention of biosimilar TCZ was 94.7%. TCZ dosing intervals were extended in four patients (10.5%), and treatment was discontinued in one patient owing to sustained remission. No disease relapses occurred. One patient developed herpes zoster, and another discontinued biosimilar TCZ following diagnosis of diverticulosis.</p><p><strong>Conclusions: </strong>Switching from originator TCZ (RoACTEMRA™) to biosimilar TCZ (TYENNE™) appears to be safe and effective in patients with GCA in routine clinical practice.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"277-284"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-Pocket Healthcare Expenditures Associated with Prescription Opioid Use in Older Adults with Non-cancer Chronic Pain.","authors":"Neill Bates, Patricia Huerta, Marissa Carraway, Jessica Zimmerman, Dmitry Tumin, David Ryan","doi":"10.1007/s40266-026-01289-7","DOIUrl":"10.1007/s40266-026-01289-7","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is a long-term illness impacting quality of life in older adults, and while opioids are frequently used to manage chronic pain in all adults, there is increased risk of medical complications in older adults stemming from opioid therapy. Therefore, we aimed to examine the relationship of prescription opioids on out-of-pocket (OOP) healthcare expenditures in a cohort of older adults (≥ 50 years) with chronic pain in the United States (US).</p><p><strong>Methods: </strong>Our analysis used data from the Health and Retirement Study, a longitudinal cohort study capturing health and lifestyle information of older adults living in the US. We employed multivariable Poisson regression with fixed effects to model how OOP expenditures change when older adults start and discontinue opioids.</p><p><strong>Results: </strong>Our sample had 7295 unique respondents with 20,738 eligible interviews. The median total OOP expenditures were higher in respondents using opioids compared to years when respondents were not (US $396 vs $308; p = 0.001). On fixed-effects Poisson regression analysis, prescription opioid use was associated with higher OOP expenditures for hospitalizations (p < 0.001), doctor/clinic visits (p < 0.001), and nursing home care (p < 0.001), but not total OOP expenditures (p = 0.314).</p><p><strong>Conclusions: </strong>Prescription opioid use is associated with increased OOP expenditures relating to inpatient, outpatient, and long-term care, suggesting that prescription opioids may not directly translate to increased prescription expenditures but indicate a period of increased healthcare vulnerability for older adults.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"285-292"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure Medications in Older Adults with Epilepsy: Considerations in Pharmacology, Safety, Tolerability, and Effectiveness of Newer Agents.","authors":"Louise M McCarthy, Kelly A Boylan, Rani A Sarkis","doi":"10.1007/s40266-026-01283-z","DOIUrl":"10.1007/s40266-026-01283-z","url":null,"abstract":"<p><p>Older adults represent one of the fastest-growing populations living with epilepsy, yet they remain underrepresented in clinical trials. In this age group, antiseizure medication selection is frequently complicated by multimorbidity, polypharmacy, age-related changes in renal and hepatic function, and vulnerability to adverse effects such as falls and cognitive impairment. Because many antiseizure medications demonstrate comparable efficacy for seizure control, medication tolerability and quality-of-life considerations often play a decisive role in treatment selection for older adults. This narrative review synthesizes available evidence on the tolerability of commonly used antiseizure medications in adults aged 65 years and older, with a focus on adverse-effect profiles, treatment retention, and clinical considerations unique to aging populations. Data from previous trials are reviewed for established agents (including levetiracetam, lamotrigine, carbamazepine, gabapentin, and pregabalin) as well as newer antiseizure medications such as lacosamide, brivaracetam, cenobamate, eslicarbazepine acetate, and perampanel. Emerging evidence suggests that newer agents demonstrate favorable efficacy and tolerability at lower doses in older adults, though falls, dizziness, and neuropsychiatric effects can be dose limiting. Newer intranasal benzodiazepine rescue therapies offer practical advantages for seizure clusters, but data specific to older adults remain limited. The review also addresses tolerability considerations related to renal and hepatic impairment, osteoporosis, anticoagulation, chemotherapy, and special populations including individuals with dementia, post-stroke epilepsy, tumor-related epilepsy, and depression. Overall, existing evidence supports the use of lower starting doses, slower titration schedules, and avoidance of enzyme-inducing antiseizure medications when possible in older adults. The heterogeneity of this population highlights the need for future studies stratified by frailty, cognitive status, and the living environment to better inform individualized tolerability-focused epilepsy care in later life.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"251-265"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implants to Treat Glaucoma: Promising or Not?","authors":"Barbara Cvenkel, Miriam Kolko","doi":"10.1007/s40266-025-01271-9","DOIUrl":"10.1007/s40266-025-01271-9","url":null,"abstract":"<p><p>Glaucoma is one of the leading causes of blindness and its prevalence increases with age. The most common form, primary open-angle glaucoma, is a chronic, slowly progressive optic neuropathy characterised by the loss of retinal ganglion cells and their axons, leading to irreversible visual field loss. Elevated intraocular pressure (IOP) is the only modifiable risk factor for glaucoma. Reducing IOP to a level that is safe for the patient's eye has been shown to slow disease progression. Lowering IOP in open-angle glaucoma is achieved by eye drops, selective laser trabeculoplasty (SLT) and/or surgery. Many patients are treated with IOP-lowering eye drops, which require lifelong continuous instillation. However, as with other chronic, asymptomatic diseases, adherence to glaucoma treatment is poor for various reasons and is associated with faster disease progression. The purpose of this review is to discuss several sustained-release systems that have been investigated to reduce IOP over time, to address barriers to adherence and improve quality of life. Among these, non-invasive drug-eluting delivery systems such as contact lenses, punctal plugs, and conjunctival ocular inserts have not reached the market. Currently, only two intracameral implants have been approved by the Food and Drug Administration for single use due to corneal safety issues. The biodegradable bimatoprost implant releases the drug continuously for 4-6 months, and its effect on IOP may extend for up to 2 years in 25% of patients. The non-biodegradable intracameral implant releases travoprost for 36 months, when it needs to be removed. However, additional data are needed to assess safety following repeated administration, as well as in broader patient populations and in combination with other treatment approaches such as SLT. Several other biodegradable intracameral implants that release prostaglandin analogues are undergoing clinical trials. In the future, intraocular implants containing genetically modified cells that secrete neurotrophic factors may potentially offer an IOP-independent neuroprotective strategy, complementing existing IOP-lowering implants in glaucoma management.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"153-162"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist-Led Deprescribing Interventions for Older Adults with Polypharmacy: A Retrospective Cohort Study of Community Pharmacy Practice in Japan.","authors":"Kenji Fujita, Noriko Sato, Ayumi Okizaki, Ruri Endo, Maho Taguchi, Sarah N Hilmer, Timothy F Chen, Kazuki Kushida, Tomoya Kudo","doi":"10.1007/s40266-025-01275-5","DOIUrl":"10.1007/s40266-025-01275-5","url":null,"abstract":"<p><strong>Background: </strong>Global aging makes polypharmacy in older adults a critical concern. Pharmacist-led deprescribing shows promise, but lacks routine implementation. Japan introduced \"the Medication Adjustment Support Fee (the Adjustment Fee)\" in 2018 for deprescribing medications in patients with polypharmacy based on pharmacists' recommendations.</p><p><strong>Objective: </strong>We aimed to investigate: (1) medication distribution among older patients; (2) medications most frequently deprescribed based on pharmacists' recommendations; and (3) factors associated with successful deprescribing.</p><p><strong>Methods: </strong>This retrospective study analysed patients aged ≥ 65 years who had prescriptions dispensed for ≥ 60 days from 2069 community pharmacies (April 2020-September 2023). Eligibility for the adjustment fee required six or more oral medications for ≥ 4 weeks, with pharmacists receiving remuneration when two or more medications were deprescribed and sustained for ≥ 4 weeks. We examined: (1) medication distribution in older patients; (2) most frequently deprescribed medications based on pharmacists' recommendations; and (3) factors associated with deprescribing using multi-level logistic regression.</p><p><strong>Results: </strong>Amongst 1,458,323 older patients, 36.9% (537,884) met the eligibility criteria for the adjustment fee, but only 0.08% had medications deprescribed based on pharmacist recommendations. At the pharmacy level, 10% of pharmacies (213/2069) claimed the fee at least once. The most frequently deprescribed medications were rebamipide (0.05%), mecobalamin (0.06%) and magnesium oxide (0.02%). Older age, higher number of medications taken, presence of a family pharmacist, and longer evaluation periods were significantly associated with claiming for the adjustment fee (p < 0.001 for all).</p><p><strong>Conclusions: </strong>Pharmacist-led deprescribing is infrequently implemented. Future studies could investigate the potential of strengthened incentives, enhanced collaboration, and robust protocols to optimize medication management in older adults.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"203-210"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Systematic Review of Strategies to Facilitate Post-Discharge Continuity of In-Hospital Medication Changes in Older Adults.","authors":"Kate J R Johnstone, Sarah N Hilmer, Sarita Lo, Lisa Kouladjian O'Donnell, Edwin C K Tan, Bonnie Liu, Nashwa Masnoon","doi":"10.1007/s40266-025-01270-w","DOIUrl":"10.1007/s40266-025-01270-w","url":null,"abstract":"<p><strong>Background: </strong>In-hospital medication changes are a key component of healthcare of older adults. It is important to employ strategies to ensure continuity of changes post-discharge.</p><p><strong>Objective: </strong>This systematic review aimed to summarise (i) strategies that have been investigated to facilitate post-discharge continuity of in-hospital medication changes in older adults and (ii) their impact on continuity of medication changes and clinical, health service utilisation and patient-reported outcomes.</p><p><strong>Methods: </strong>MEDLINE and EMBASE databases were searched (1946-20/03/2024) to identify strategies that facilitate post-discharge continuity of hospital medication changes and assess their impact on continuity, health service utilisation, and clinical and patient-reported outcomes post-discharge in older adults (mean/median age ≥60 years).</p><p><strong>Results: </strong>After screening 800 articles, 49 met inclusion criteria, including 25 quasi-experimental studies, 14 randomised controlled trials, four cohort studies, four observational studies, one case series, and one retrospective case note review and audit. Strategies commonly involved providing discharge medication lists to patients and/or their general practitioners (36/49 studies, 73.5%), discharge counselling (28/49, 57.1%) and medication reconciliation (28/49, 57.1%). Most studies used multi-component strategies (39/49, 79.6%) by multi-disciplinary teams (28/49, 57.1%). Twenty-six of the 36 studies (68.4%) assessing the impact of strategies on continuity reported significant improvements in continuity-related outcomes. Thirteen out of the 21 studies (61.9%) that measured medication discrepancies (most common measure of continuity) reported significant reductions following strategy implementation. One out of 11 studies (9.1%) reported a significant improvement in clinical outcomes, while none of the 13 studies found significant improvements in health service utilisation outcomes. Two of three studies investigating patient-reported quality of life reported significant improvements.</p><p><strong>Conclusions: </strong>Strategies focus on communicating medication changes to patients, general practitioners and community pharmacists by multi-disciplinary hospital clinicians. There is evidence of a positive impact of multi-component strategies delivered by a multi-disciplinary team on continuity of medication changes and quality of life post-discharge. Future analyses investigating strategy complexity and cost effectiveness may inform their translation into practice.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"137-152"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Persistence After Starting Bictegravir- or Dolutegravir-Based Regimens Among Adults Aged ≥50 Years with HIV in the United States.","authors":"Amanda M Kong, Jacqueline Lucia, Mary J Christoph, Uche Mordi, Daisha Joseph, Gulce Askin, Daniela Yucuma, Neia Prata Menezes, Peter McMahon, Travis Lim","doi":"10.1007/s40266-026-01279-9","DOIUrl":"10.1007/s40266-026-01279-9","url":null,"abstract":"<p><strong>Background: </strong>Persistence and adherence to antiretroviral therapy (ART) are crucial for effective viral suppression and may be impacted by comorbidities and polypharmacy in older people with HIV (PWH). This study compared ART persistence among treatment-naive and treatment-experienced PWH aged ≥50 years who received bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) versus dolutegravir (DTG)-based regimens.</p><p><strong>Methods: </strong>This observational, retrospective study utilized US medical and pharmacy claims data from HealthVerity Marketplace (1 January 2015 to 29 February 2024). PWH were aged ≥50 years and received B/F/TAF, dolutegravir/lamivudine (DTG/3TC), dolutegravir/abacavir/lamivudine (DTG/ABC/3TC), or DTG-based multitablet regimens (MTRs). Baseline characteristics were balanced using inverse probability of treatment weighting. Time to nonpersistence (i.e., discontinuation or switching) was depicted using Kaplan-Meier plots. Risk of nonpersistence was modeled using weighted Cox proportional hazards models.</p><p><strong>Results: </strong>Overall, 32,448 PWH aged ≥50 years were included in the analysis; 77% were treatment experienced. Among treatment-experienced PWH, those who received B/F/TAF had significantly lower adherence during the baseline period than those who received DTG/3TC and significantly higher adherence during the baseline period than those who received DTG/ABC/3TC and DTG-based MTRs. Nonetheless, persistence on B/F/TAF was longer than DTG/ABC/3TC and DTG-based MTRs in both subgroups. Treatment-naive and treatment-experienced PWH who received B/F/TAF had significantly lower hazards of nonpersistence versus those who received DTG/ABC/3TC and DTG-based MTRs (all p < 0.001), as did treatment-naive PWH who received B/F/TAF versus DTG/3TC (p = 0.031).</p><p><strong>Conclusions: </strong>B/F/TAF was associated with higher persistence than other ART regimens among older PWH. Findings underscore the importance of tailored ART selection to address the unique challenges faced by older PWH.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"175-187"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional and Longitudinal Analyses of the Association Between Statin Use and Age-Related Hearing Loss.","authors":"Lizmarie G Maldonado, Lois J Matthews, Katharine A Fernandez, Annie N Simpson, Lisa L Cunningham, Judy R Dubno","doi":"10.1007/s40266-025-01268-4","DOIUrl":"10.1007/s40266-025-01268-4","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence in animal models and humans suggests that statins may provide partial protection against noise-induced and drug-induced hearing loss. However, evidence for protection against age-related hearing loss (ARHL) is mixed, and longitudinal studies in large adult cohorts from the general population are limited. This study examined the association between statin use and ARHL in a diverse, community-based longitudinal cohort of adults across the lifespan.</p><p><strong>Methods: </strong>The 1239 participants, aged ≥ 55 years, are from the MUSC Longitudinal Cohort Study of Age-Related Hearing Loss (1988-present). Following a comprehensive baseline examination, participants attended annual examinations during which audiometric and statin use data were collected. Multivariable linear regression models were performed on baseline data for cross-sectional analyses, and general linear mixed models were performed on longitudinal data to assess the association between statin use, two types of statins, and hearing over time. Hearing outcomes include four pure-tone averages (PTA): narrow (0.5, 1.0, 2.0, and 4.0 kHz), low frequency (0.25, 0.5, and 1.0 kHz), broad (0.5, 1.0, 2.0, 3.0, 4.0, 6.0, and 8.0 kHz), and high frequency (2.0, 3.0, 4.0, 6.0, and 8.0 kHz). Missing covariate data were imputed with multiple imputation using chain equations (MICE).</p><p><strong>Results: </strong>Statin use (versus no use) was associated with better hearing at baseline for the broad and high-frequency PTAs for adults aged 55-64 and 65-74 years. However, this statin benefit was not observed for the 75+-year age group and for all participants when hearing was examined over time. Without age stratification, similar results were observed for atorvastatin use but not for simvastatin use.</p><p><strong>Conclusions: </strong>Overall, the findings suggest statin benefits for mid-to-high frequency hearing for middle-aged to older adults at early stages of ARHL. On the basis of evidence suggesting that some statins have beneficial effects on hearing, well-controlled clinical trials are needed to examine effects of statin use and statin types on ARHL in the general population.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"189-201"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Australian Polypharmacy Trends Between 2013 and 2024: A Repeated Cross-Sectional Study in the Adult Population.","authors":"Georgie B Lee, Christopher Etherton-Beer, Julie A Pasco, Osvaldo P Almeida, Erin Kelty, David B Preen, Frank M Sanfilippo, Amy T Page","doi":"10.1007/s40266-025-01274-6","DOIUrl":"10.1007/s40266-025-01274-6","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this repeated cross-sectional study was to estimate polypharmacy prevalence and trends in Australian adults between 2013 and 2024.</p><p><strong>Methods: </strong>Dispensing records of medicines subsidised by the Australian Pharmaceutical Benefits Scheme (PBS) were analysed for a nationally representative 10% sample of PBS-eligible beneficiaries.</p><p><strong>Outcomes: </strong>The outcomes for this study were annual polypharmacy and hyperpolypharmacy prevalence, defined as ≥5 and ≥10 regular medicines, respectively, and average annual percentage change (AAPC), overall and by gender-stratified age groups. These groups are defined broadly as adult (18-64 years) and older adult (≥65 years), and as younger adulthood (18-39 years), middle (40-64 years), early older (65-84 years) and later older (85+ years) age.</p><p><strong>Results: </strong>Polypharmacy prevalence rose from 8.0% in 2013 to 9.2% (AAPC+1.4%), with two million Australians exposed in 2024. Although prevalence was initially higher among women, by 2024 men had surpassed women from middle age onward. Increasing AAPC was observed among adult and older adult men (+1.0%, +1.3%), while remaining stable among women. Finer age strata showed growth among men in middle, early older, and later older age (+1.7%, +1.0%, +3.4%) and divergent trends among women, with increases in younger adulthood (+1.8%) and declines in early older age (- 0.7%).</p><p><strong>Conclusion: </strong>Shifting gender trends appear driven by stabilising or declining prevalence among women alongside sustained growth among men. By 2024, men exceeded women from middle age onward, suggesting a changing prescribing landscape. These patterns highlight the need for targeted interventions, and gender-stratified monitoring to ensure prescribing is appropriate. The long-term consequences of increasing polypharmacy in younger and middle-aged adults remain unclear and warrant further investigation.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"163-174"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methotrexate for Osteoarthritis: What Does the Evidence Say?","authors":"Marina De Castro Fidalgo E Costa, Frederique Ponchel, Kierran Flack, Philip G Conaghan, Sarah R Kingsbury","doi":"10.1007/s40266-025-01276-4","DOIUrl":"10.1007/s40266-025-01276-4","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a leading cause of disability worldwide, characterised by chronic pain and reduced quality of life. Despite its prevalence, pharmacotherapy options remain limited. Inflammation has emerged as a promising target, with anti-inflammatory agents used in other rheumatological conditions, such as methotrexate (MTX), being explored for OA treatment. MTX is a cornerstone therapy in rheumatoid arthritis (RA), owing to its broad immunomodulatory properties and well-established clinical efficacy. This review summarises evidence from seven randomised controlled trials and two observational studies investigating MTX in knee and hand OA. Studies varied considerably in terms of sample size, study population, MTX dosage and follow-up duration. Overall, study outcomes were conflicting in terms of MTX effect on OA symptoms. However, trials with larger sample sizes and higher MTX doses (> 15 mg/week) consistently reported benefits for pain in knee and hand OA, with a favourable safety profile, supporting MTX as a potential OA treatment. There is still a need for further research to refine dosing strategies, assess longer term use and evaluate cost-effectiveness. Given the complex heterogeneity of OA, stratification by OA phenotype, particularly consideration of local and systemic inflammation, may also be important to underpin selection of a population most likely to respond to MTX treatment. Considerations for the use of MTX in older adults, where comorbidities and polypharmacy may impact use, will also be essential for clinical implementation.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"123-136"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}