Late onset rheumatoid arthritis an observational study

Area of Science:

• Rheumatology
• Immunology

Background:

• Rheumatoid arthritis (RA) can manifest later in life, a condition termed late-onset rheumatoid arthritis (LORA), typically defined as onset at age 60 or older.
• Understanding the distinct clinical, laboratory, radiological, and treatment profiles of LORA compared to early-onset RA (EaORA) is essential for optimizing patient care.

Purpose of the Study:

• To compare the clinical, laboratory, radiological, and treatment characteristics of patients with LORA against those with EaORA.
• To identify specific features of LORA that differentiate it from EaORA in patients with similar disease durations.

Main Methods:

• An observational, single-center study involving 120 patients diagnosed with RA.
• Patients were divided into two groups: 60 with LORA (onset ≥ 60 years) and 60 with EaORA (onset < 60 years), matched for disease duration.

Main Results:

• LORA patients exhibited significantly higher disease activity (DAS28-ESR) and more frequent involvement of large joints, specifically shoulders and knees.
• Radiological erosive changes were more prevalent in the LORA group. While rheumatoid factor (RF) positivity did not differ, anti-citrullinated protein antibody (ACPA) positivity was higher in the EaORA group.
• LORA patients showed elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels, and lower hemoglobin levels compared to EaORA patients. Methotrexate and sulfasalazine were the most common disease-modifying antirheumatic drugs (DMARDs) used; biological therapies were not administered.

Conclusions:

• Late-onset rheumatoid arthritis (LORA) is characterized by increased disease activity, greater involvement of major joints, and more severe structural damage compared to early-onset RA (EaORA).
• These distinct features of LORA necessitate tailored clinical approaches and treatment considerations in managing older adult RA patients.