Clinical study of elderly patients with rheumatoid arthritis

DOI 1 Citations
  • Kuroda Takeshi
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Hasegawa Eriko
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Wakamatsu Ayako
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Sato Hiroe
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Kobayashi Daisuke
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Nakatsue Takeshi
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Narita Ichiei
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Wada Yoko
    Department of Rheumatology, Niigata Rinko Hospital
  • Nakano Masaaki
    Clinical Laboratory Department, Nagaoka Central General Hospital

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Other Title
  • 高齢関節リウマチ患者の臨床的検討

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Abstract

<p>Objectives: We compared data for rheumatoid arthritis（RA）patients obtained between 1991 and 2018 to clarify the current clinical picture of RA in elderly patients.</p><p>Methods: RA cases seen at our department in 1991 and 2018 were evaluated. The patient ages and sex ratios in the two groups were compared, and the clinical features of patients with younger-onset RA（YORA; onset age <65 years）and patients with elderly-onset RA（EORA; onset age ≥ 65 years）in the 2018 group were evaluated.</p><p>Results: We evaluated 429 and 368 RA cases seen at our department in 1991 and 2018, respectively. The clinical features of 260 patients with younger-onset RA（YORA; onset age <65 years）and 108 patients with elderly-onset RA（EORA; onset age ≥ 65 years）in the 2018 group were evaluated. The peak age at RA onset was 50s-60s in 1991 and 60s-70s in 2018. In 1991, the male-female ratios in the <65-yr and ≥ 65-yr age groups were 0.14 and 0.19, respectively, whereas the corresponding ratios in 2018 were 0.25 and 0.38, respectively. The frequencies of RF-positive and ACPA-positive patients with, YORA were both higher than those with EORA（P<0.05）. Among other features after diagnosis, AA amyloidosis was observed in only 6（1.6%）of the RA patients. MTX were used in 64% of YORA patients and 33% of EORA patients, the difference being significant（p<0.001）. Biological agents were used in 38% of YORA patients and 22% of EORA patients, the difference being significant（p<0.01）.</p><p>Conclusion: The characteristics of EORA patients differ from those of YORA patients. In YORA, attention to amyloid is also required in view of the fact that treatment was insufficient in the past. Pharmacotherapy should be based on the characteristics of aging in elderly patients with RA.</p>

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