The clinical features of elderly‐onset rheumatoid arthritis. A comparison with younger‐onset disease of similar duration

Wiley - Tập 28 Số 9 - Trang 987-994 - 1985
Chad Deal1,2, Robert F. Meenan1, Don L. Goldenberg1, Jennifer J. Anderson1, B. Sack1, Robert S. Pastan1, Alan S. Cohen1
1Arthritis Center of Boston University, the Departments of Medicine, University and Boston City Hospitals, and the Thorndike Memorial Laboratory, Boston City Hospital, Boston, Massachusetts
2Case Western Reserve University, Lakeside Hospital, 2073 Abington Road, Cleveland, OH 44106

Tóm tắt

AbstractPatients with elderly‐onset rheumatoid arthritis (EORA) may represent a clinical subset of individuals who differ prognostically and therapeutically from patients with younger‐onset disease (YORA). In order to test this hypothesis, we reviewed the records of 212 patients with rheumatoid arthritis and grouped them according to age at onset above or below 60 years old. Seventy‐eight EORA patients and 134 YORA patients with disease duration of ⩽10 years were used for a comparison of presenting features and disease outcome. Abrupt onset occurred somewhat more frequently in EORA, but was not associated with a significantly different clinical course than was an insidious presentation in this older group. There were no differences between the EORA and YORA groups in terms of mean initial joint score, although the scores for the YORA group had wider variation. An initial clinical presentation resembling polymyalgia rheumatica (PMR) was 4 times as frequent in EORA. Elderly patients were less likely to have subcutaneous nodules or rheumatoid factor at disease onset. At the final examination, the EORA patients had lower joint scores and higher health assessments despite similar courses of treatment. These outcome differences persisted when patients with PMR‐like presentations were excluded. Multivariate analyses indicated that joint scores and disease duration made important contributions to a better outcome of EORA, whereas PMR presentation and abrupt onset did not. After an adjustment was made for these 4 features, age at onset was an important contribution to joint score outcome. These results confirm the existence of important differences in onset, clinical features, and prognosis between patients with EORA and those with YORA.

Từ khóa


Tài liệu tham khảo

10.1001/jama.1962.03050340001001

10.1136/ard.29.3.254

10.1016/S0025-7125(16)32894-2

10.1016/0002-9343(79)91055-6

10.1016/0049-0172(76)90013-5

10.1002/art.1780250503

Terkeltaub R, 1984, An immunogenetic study of older age onset rheumatoid arthritis, J Rheumatol, 11, 147

10.1136/bmj.1.5905.444

Ehrlich GE, 1970, Rheumatoid arthritis in the aged, Geriatrics, 25, 103

Terkeltaub R, 1983, A clinical study of older age rheumatoid arthritis with comparison to a younger onset group, J Rheumatol, 10, 418

10.3109/rhe1.1968.14.issue-1-4.31

Brown JW, 1967, The onset of rheumatoid arthritis in the aged, J Am Geriatr Soc, 10, 873, 10.1111/j.1532-5415.1967.tb02518.x

10.1016/0002-9343(51)90288-4

Ropes MW, 1958, 1958 revision of diagnostic criteria for rheumatoid arthritis, Bull Rheum Dis, 9, 175

10.1002/art.1780261201

10.1001/jama.1949.02900430001001

10.7326/0003-4819-100-1-122

10.1002/9780470316542.ch6

10.1111/j.1532-5415.1979.tb06444.x

Ehrlich GE, 1978, Polymyalgia rheumatica, JAMA, 240, 57, 10.1001/jama.1978.03290010061030

10.7326/0003-4819-97-5-672

10.1136/ard.26.2.103

O'Duffy JD, 1976, Joint imaging in polymyalgia rheumatica, Mayo Clin Proc, 51, 519

O'Duffy JD, 1980, A follow‐up study of polymyalgia rheumatica: evidence of chronic axial synovitis, J Rheumatol, 7, 685

Thông tin
Thông tin xuất bản

Wiley

Tập 28 Số 9

987-994

Thông tin tác giả