scholarly journals Should we reconsider the definition of elderly-onset rheumatoid arthritis in an ageing society?

2021 ◽  
Author(s):  
Shunsuke Uchiyama ◽  
Satoshi Takanashi ◽  
Mitsuhiro Takeno ◽  
Takahisa Gono ◽  
Yuko Kaneko ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Disability ◽  
Characteristic Curve ◽  
Disease Onset ◽  
Health Assessment ◽  
Area Under The Curve ◽  
Nippon Medical School ◽  
Ageing Society ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis

ABSTRACT Objectives The management of elderly-onset rheumatoid arthritis (EORA) is challenging due to progressive functional disability, increased comorbidities, and high drug-related risks. EORA is defined as disease onset after 60 years since 1985. We assessed whether this cut-off age was optimal in a progressively ageing society. Methods This study used two cohorts of consecutive rheumatoid arthritis (RA) patients: the Nippon Medical School (NMS) cohort (n = 204) and the Keio cohort (n = 296). Clinical findings independently correlated with the age of RA onset were selected as ‘EORA features’ from previously reported EORA characteristics using univariable and multivariable regression analyses. Receiver operating characteristic curve analysis was conducted to determine the cut-off age that best selected patients with all EORA features. Results Acute onset, negative anti-cyclic citrullinated peptide antibody, and high erythrocyte sedimentation rate were selected as ‘EORA features’ in both cohorts. Patients with all EORA features were more numerous with age and almost exclusively older than 65 years. The optimal EORA cut-off age was 73 years with an area under the curve (AUC) of 0.82 in the NMS cohort and 68 with an AUC of 0.93 in the Keio cohort. In the NMS cohort, Health Assessment Questionnaire-Disability Index and comorbidities in patients with disease onset between 60 years and the projected cut-off age were similar to those in younger-onset RA, but differed from those in patients with disease onset older than the projected cut-off age. Conclusion The optimal EORA cut-off age was greater than the conventional definition, but this needs to be validated in different patient populations.

scholarly journals Comparative Analyses of Serological Biomarkers and Disease Characteristics between Elderly-onset and Younger-onset Rheumatoid Arthritis

2021 ◽  
Vol 16 (1) ◽  
pp. 237-245
Author(s):  
Rajalingham Sakthiswary ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Disease Duration ◽  
Severe Disease ◽  
Age At Onset ◽  
Health Assessment ◽  
Joint Damage ◽  
Study Data ◽  
Elderly Onset

The onset of rheumatoid arthritis (RA) may occur any time after the age of 16 years. The purpose of this study was to compare the clinical and serological differences between elderly onset RA (EORA); which is begins at the age of 60 and above, with younger onset RA (YORA). A total of 69 EORA and 82 YORA female patients were enrolled in this study. Data on medications, disease duration, age at onset, disease activity at onset and laboratory parameters were collected by reviewing the medical records. All patients had their blood samples taken for serum anticyclic citrulinated peptide (anti-CCP), IgA rheumatoid factor (RF), IgM RF and IgG RF. Besides, the subjects were assessed for their radiographic joint damage based on Modified Sharp Score (MSS) and functional disability based on the Health Assessment Questionnaire-disability Index (HAQ-DI) scores. Despite comparable disease duration and frequency of seropositivity, the YORA group had significantly higher disease activity at onset of the disease (p=0.009). In keeping with this finding, the YORA group had more severe joint damage based on radiographic assessment (MSS scores of 17.49+19.04 versus 10.04+12.79). The YORA group had significantly higher levels of IgA RF and anti-CCP with p-values of 0.035 and 0.002, respectively. Our findings suggest that YORA is associated with more severe disease, worse radiographic joint damage and higher levels of anti-CCP and IgA RF.

Do Patients with Elderly-Onset Rheumatoid Arthritis Have Severe Functional Disability?

2012 ◽  
Vol 42 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Soo-Kyung Cho ◽  
Yoon-Kyoung Sung ◽  
Chan-Bum Choi ◽  
Hoon-Suk Cha ◽  
Jung-Yoon Choe ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Disability ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis

Similarity of response to biologics between elderly-onset rheumatoid arthritis (EORA) and non-EORA elderly patients: from the FIRST registry

2021 ◽  
pp. jrheum.201135
Author(s):  
Sae Ochi ◽  
Fumitaka Mizoguchi ◽  
Kazuhisa Nakano ◽  
Yoshiya Tanaka
Keyword(s):  
Rheumatoid Arthritis ◽  
Elderly Patients ◽  
Disease Activity ◽  
Trajectory Analysis ◽  
Response Patterns ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Elderly Onset ◽  
Disease Modifying ◽  
Elderly Onset Rheumatoid Arthritis

Objective Increasing numbers of patients are developing rheumatoid arthritis (RA) at an older age, and optimal treatment of elderly-onset RA (EORA) patients is attracting greater attention. This study aimed to analyze the efficacy and safety of biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in EORA and non-EORA elderly patients. Methods A cohort of RA patients treated with b/tsDMARDs were retrospectively analyzed. Among patients who were ≥60 years old, those who developed RA after age 60 years were categorized as EORA, while others were categorized as non-EORA elderly. Disease activity were compared between the EORA and non-EORA elderly groups. Results In total, 1,040 patients were categorized as EORA and 710 as non-EORA elderly. There were not significant differences in characteristics at baseline between the two groups. The proportion of patients with low and high disease activity was comparable at week 2, 22 and 54 between in the EORA and the non-EORA elderly group. There was not significant difference in reasons of the discontinuation of b/tsDMARDs between the two groups. Elderly onset did not affect changes in CDAI and HAQ-DI as well as reasons of the discontinuation between the two groups. The trajectory analysis on CDAI-responses to b/tsDMARDs for 54 weeks identified three response patterns. The proportions of patients categorized into each group and CDAI-response trajectories to b/tsDMARDs were very similar between EORA and non-EORA elderly patients. Conclusion CDAI response patterns to b/tsDMARDs and hazard ratio of adverse events were similar between EORA and non-EORA elderly patients.

Clinical Characteristics of Elderly Onset Rheumatoid Arthritis

2010 ◽  
Vol 14 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Hyun Ok Kim ◽  
Ho Sung Yoon ◽  
Seung Ki Kwok ◽  
Ji Hyeon Ju ◽  
Kyung Su Park ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Characteristics ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis

scholarly journals Association among B lymphocyte subset and rheumatoid arthritis in a Chinese population

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Haiyan You ◽  
Mengwei Cheng ◽  
Cui Ma ◽  
Wenjuan Zheng ◽  
Yu Jiang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Subjects ◽  
B Lymphocyte ◽  
Lymphocyte Subsets ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Enzyme Linked Immunosorbent Assay ◽  
Roc Curve Analysis ◽  
Autoantibody Production ◽  
Plasma Cytokines

Abstract Background and aim Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters. Methods In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction. Results The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing RA was 0.831 (95% CI 0.748 ~ 0.915), the specificity was 91.4%, and the sensitivity was 67.5%. The AUC predicted by the combination of plasmablast and anti-CCP for active RA patients was 0.760, which was higher than that of plasmablast and anti-CCP. Conclusion In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA.

Elderly-onset rheumatoid arthritis

2010 ◽  
Vol 77 (4) ◽  
pp. 290-296 ◽  
Author(s):  
Martin Soubrier ◽  
Sylvain Mathieu ◽  
Sarah Payet ◽  
Jean-Jacques Dubost ◽  
Jean-Michel Ristori
Keyword(s):  
Rheumatoid Arthritis ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis

scholarly journals AB0269 COMPARISON BETWEEN DIFFERENT DISEASE ACTIVITY SCORES IN ELDERLY ONSET RHEUMATOID ARTHRITIS

2019 ◽  
Author(s):  
Melania Martínez-Morillo ◽  
águeda Prior-Español ◽  
Anahy Brandy-Garcia ◽  
Susana Holgado ◽  
María Aparicio-Espinar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis
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