Background Rheumatoid arthritis (RA)'s prevalence increases with age. The average life expectancy is getting longer and global population is becoming older. Physicians will be challenged with the recognition and treatment of RA patients who may have different physical conditions, comorbid diseases and using multi-drugs.
Objectives The aim of this study was to evaluate the clinical characteristics and treatment modalities in elderly RA patients.
Methods We assessed elderly RA patients (≥65 years) diagnosed according to 2010 American College of Rheumatology (ACR) criteria. Clinical and laborotary findings, treatment durations, dose of drugs and treatment related adverse effects were recorded into a pre-defined protocol. “Disease Activity Score” (DAS-28), “Physician Global Assessment” (PGA) and “Health Assessment Questionnaire” (HAQ) scores were used as composite indices for RA activity evaluation.
Results Seventy-four RA patients [54 patients (73%) were female] with a mean age of 71±5 (65–86) years were included into the study,. The mean total disease duration of these patients was 97±104 (9–600) months. Disease onset was in the elderly period for 40 (55%) patients. Small joints of hands were the most frequently involved joints (95%). Seropositivity rate was 66% and 56% of the patients had erosive disease. DAS-28 and HAQ scores were correlated with PGA scores (p:0,001). The proportion of patients with high and moderate disease activity was found as 79% according to DAS-28 scores. There was no association between age and antibody titers or activity indices. Non-steroidal antiinflammatory drugs (NSAIDs) were part of the treatment in 53 patients (71%) and no severe side effects associated with NSAIDs were observed. The mean cumulative prednisolone dose was 7617±10602 mg. Hypertension and osteoporosis were the most frequent comorbidities (64% and 48%, respectively). The most commonly used disease modifying antirheumatic drug (DMARD) was methotrexate (76%) and the rate of compliance was found high for all drugs except sulfasalazine (Table 1). While 60% of all patients were treated with DMARD monotherapy, combination DMARD therapy were used in 37% of patients. The rate of biologic theraphy was found as 12% (9 patients) in all study population.
Conclusions In this preliminary data from our ongoing study, elderly RA patients had remarkable compliance with NSAIDs and DMARDs. Although patients treated with biologic agents constituted a small group, no serious side effect that required cessation of the treatment was observed. By the increasing numbers of elderly RA patients in our cohort, we expect to obtain more powerful data on compliance and safety issues of the treatment and particularly biologic agents.
Disclosure of Interest None declared