[Rheumatological care of older people : Annual report 2026 from the National Database of the regional Collaborative...

The rheumatological management of older people with inflammatory rheumatic diseases (iRMD) is becoming increasingly more important. The 2026 annual report from the National Database (NDB) of the Collaborative Arthritis Centers focusses on characteristics of older patients with iRMD as well as on developments in drug therapy.

Within the NDB, patients under routine outpatient rheumatology care and the treating rheumatologists document disease outcomes, progression and treatment once a year. Data from 2010-2024 were included and analyzed by age groups.

In 2024 a total of 13,416 patients from 14 rheumatology centers were included; 52% were ≥ 60 years old. The most common iRMD in patients aged ≥ 60 years were rheumatoid arthritis (RA 57%), psoriatic arthritis (PsA 12%), axial spondyloarthritis (axSpA 7%), polymyalgia rheumatica (PMR 6%) and giant cell arteritis (GCA 5%). The mean number of comorbidities increased with age, from 1.3 (18-39 years) to 4.4 (≥ 80 years). Women experienced more functional limitations and more pain in higher age groups. Older patients more frequently received glucocorticoids and analgesics but received biologics less frequently than younger adults. For example, RA patients ≥ 80 years, as compared to patients aged 18-39 years, received 25% (≥80 years) vs. 47% (18-39 years) biologics and 37% vs. 13% glucocorticoids. Nevertheless, changes still followed the general trend. Since 2010, the use of biologic disease-modifying antirheumatic drugs (bDMARD) increased from 7% to 25% among RA patients aged ≥ 80 years, while glucocorticoids decreased from 63% to 37%.

Despite overall lower use of biologics in older age groups, long-term data from the NDB show that biologics are being prescribed more frequently also to older patients compared to previous calendar years.