Comparison of elderly and young onset rheumatoid arthritis

Abstract

Objective: To describe demographic, clinical, paraclinical and therapeutic characteristics of elderly onset (EORA) compared to young-onset (YORA) rheumatoid arthritis. Patients and Methods: We studied 50 EORA and 100 YORA. Socio-demographic characteristics, clinical and paraclinical data of the disease were collected as well as the treatments assigned to patients. EORA patients were defined as disease onset ≥ 60 years. Results: At the study visit, EORA patients had a mean age of 68.3 ± 6.4 years old and YORA patients were aged 42.5 ± 9.1 years old. A male predominance was noted in EORA group than the YORA group (38% vs. 12%, p <0.001). The onset of disease in EORA was more acute (p <0.001) with more systemic symptoms (p <0.001). EORA patients had higher Disease Activity Score of 28 joints (DAS28) (p=0.03) and higher erythrocyte sedimentation rate (ESR) (40 [10-110] vs. 28 [2-88], p=0.015). There was no significant difference in seropositive character, prevalence of radiographic erosions or joint deformity. The EORA patients had a higher Health Assessment Questionnaire (HAQ) (1 [0.4-2.2] vs. 0.6 [0.2-2], p<0.001) and more comorbidities (84% vs. 37%, p<0.001). Methotrexate was the most conventional synthetic disease-modifying antirheumatic drugs used in the two groups (95% in the YORA and 96% in the EORA; p=0.740). The EORA group received fewer biologic drugs than the YORA group (30% vs. 47 %; p=0.041). Conclusions: There were more male in EORA group. Activity and HAQ was higher in the EORA group. The EORA had more comorbidities which may explain the lesser use of biological treatments.

Keywords

• rheumatoid arthritis
• elderly onset
• young-onset
• disease activity
• life quality
• comorbidities
• disease modifying antirheumatic drugs