International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation.

• Tác giả: Nouran M Abaza, Ahmed M Abdalla, Enas A Abdelaleem, Suzan S Al-Adle, Marwa A Amer, Nahla N Eesa, Mervat I Abd Elazeem, Samah A El-Bakry, Hatem H El-Eishi, Dina F El-Essawi, Khaled El-Hadidi, Tahsin El-Hadidi, Hanan M El-Saadany, Nora Y Elsaid, Ahmed Elsaman, Saad M Elzokm, Hanan M Fathi, Rasha M Fawzy, Samar M Fawzy, Nada M Gamal, Tamer A Gheita, Nevin Hammam, Amira M Ibrahim, Maha E Ibrahim, Faten Ismail, Eman F Mohamed, Reem Hamdy A Mohammed, Doaa Mosad, Abdelhfeez Moshrif, Samah I Nasef, Maha Nassr, Nermeen Samy, Safaa Sayed, Zahraa I Selim, Soha Senara, Rawhya El Shereef, Hanan Taha, Samar Tharwat
• Ngôn ngữ: eng
• Ký hiệu phân loại: 630.715 Adult education and on-the-job training
• Thông tin xuất bản: Germany : Clinical rheumatology , 2025
• Bộ sưu tập: NCBI
• ID: 679783

Tóm tắt

 BACKGROUND: Elderly-onset rheumatoid arthritis (EORA) may have peculiar findings compared to juvenile-onset RA (JORA). The aim of the work was to present and compare the clinical characteristics of RA patients with JORA and elderly-onset EORA to a group of cases with adult-onset (AORA) and to contrast the findings worldwide. METHODS: The study included 1100 adult RA patients: 209 JORA and 329 EORA, compared with 562 AORA extracted from a big data national study on 10,364 RA patients. Clinical characteristics, laboratory investigations, medications received, and co-morbidities were recorded. The disease activity index (DAS28) and health assessment questionnaire (HAQ) were estimated. RESULTS: The JORA cases represented 19% and EORA 29.9% of the included cohort. The mean age at onset for JORA, EORA, and AORA were 15.1 ± 2.1, 64 ± 4.2, and 36.4 ± 10 years (p <
  0.0001), and the female-male ratio was 6.2:1, 2.7:1, and 7.3:1 (p <
  0.0001), respectively. In EORA, body mass index (28.8 ± 5.8) and frequencies of smokers (11.6%), diabetes (12.2%), hypertension (19.8%), and osteoporosis (5.2%) were significantly higher than in JORA (26.02 ± 5
  5.3%, 2.9%, 3.8%, and 1%) and AORA (27.6 ± 5.6
  3%, 8.4%, 14.9%, and 2.3%, p = 0.016) (p <
  0.0001, p = 0.001, p <
  0.0001, and p = 0.009, respectively). In JORA, oral ulcers were significantly more frequent (p = 0.04)
  in EORA, cardiovascular manifestations (p <
  0.0001) and hypothyroidism (p = 0.039) were more frequent
  and DAS28 (p = 0.01) and HAQ (p = 0.038) were higher. Fibromyalgia and methotrexate administration were significantly more frequent in AORA (p <
  0.0001 and p = 0.04, respectively). Rheumatoid factor, anti-cyclic citrullinated peptide, and double seropositivity were significantly more frequent in EORA (p <
  0.0001, p = 0.008, and p = 0.002, respectively). CONCLUSION: Comorbidities, cardiovascular manifestations, hypothyroidism, higher disease activity, and functional disability are more common in EORA patients. Key Points • Juvenile-onset and elderly-onset RA patients have notable differences compared to the adult-onset cases. • Co-morbidities and certain manifestations, including cardiovascular disease and hypothyroidism, as well as higher disease activity and functional disability, are more common in elderly-onset patients. • Fibromyalgia remains more frequent in adult-onset cases.