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Geriatric Rheumatology pp 145–150Cite as

Elderly Onset Rheumatoid Arthritis

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Abstract

As the number of people who are over the age of 60 years is growing in the general population, the prevalence of disability from rheumatoid arthritis (RA) is also on the rise. This is an important health concern for patients, their families, and society. This review highlights various aspects of elderly onset RA (EORA), including differences from younger onset RA (EORA), diagnostic and prognostic factors, differential diagnosis, and treatment modalities. There are challenges associated with diagnosis and treatment in the early onset rheumatoid arthritis patients. Knowledge about various aspects of early onset rheumatoid arthritis and further research into better diagnostic and therapeutic methods will help diminish the affects of this disabling disease in the older population.

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References

  1. Rasch EK, Hirsch R, Paulose-Ram R, Hochberg MC. Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: effect of different methods of case classification. Arthritis Rheum. 2003;48:917–26.

    Article  PubMed  Google Scholar 

  2. Chang J, Kavanaugh A. Novel therapies for rheumatoid arthritis. Pathophysiology. 2005;12:217–25.

    Article  PubMed  CAS  Google Scholar 

  3. Feldmann M, Brennan FM, Maini RN. Role of cytokines in rheumatoid arthritis. Annu Rev Immunol. 1996;14:397–440.

    Article  PubMed  CAS  Google Scholar 

  4. van Schaardenburg D, Breedveld FC. Elderly-onset rheumatoid arthritis. Semin Arthritis Rheum. 1994;23:367–78.

    Article  PubMed  Google Scholar 

  5. van der Heijde DM, van Riel PL, van Leeuwen MA, van Hof MA, van Rijswijk MH, van de Putte LB. Older versus younger onset rheumatoid arthritis: results at onset and after 2 years of prospective follow up of early rheumatoid arthritis. J Rheumatol. 1991;18:1285–9.

    PubMed  Google Scholar 

  6. Glennas A, Kvien TK, Andrup O, Karstensen B, Munthe E. Recent onset arthritis in the elderly: a 5 year longitudinal observational study. J Rheumatol. 2000;27:101–8.

    PubMed  CAS  Google Scholar 

  7. Deal CL, Meenan RF, Goldenberg DL, Anderson JJ, Sack B, Pastan RS, et al. The clinical features of elderly-onset rheumatoid arthritis: a comparison with younger-onset disease of similar duration. Arthritis Rheum. 1985;28:987–94.

    Article  PubMed  CAS  Google Scholar 

  8. Ferraccioli GF, Cavalieri F, Mercadanti M, Conti G, Viviano P, Ambanelli U. Clinical features, scintiscan characteristics and X-ray progression of late onset rheumatoid arthritis. Clin Exp Rheumatol. 1984;2:157–61.

    PubMed  CAS  Google Scholar 

  9. Kavanaugh AF. Rheumatoid arthritis in the elderly: is it a different disease? Am J Med. 1997;103:40S–8.

    Article  PubMed  CAS  Google Scholar 

  10. Palosuo T, Tilvis R, Strandberg T, Aho K. Filaggrin related antibodies among the aged. Ann Rheum Dis. 2003;62:261–3.

    Article  PubMed  CAS  Google Scholar 

  11. Oka M, Kytila J. Rheumatoid arthritis with the onset in old age. Acta Rheumatol Scand. 1957;3:249–58.

    PubMed  CAS  Google Scholar 

  12. Terkeltaub R, Esdaile J, Decary F, Tannenbaum H. A clinical study of older age rheumatoid arthritis with comparison to a younger onset group. J Rheumatol. 1983;10:418–24.

    PubMed  CAS  Google Scholar 

  13. Corrigan AB, Robinson RG, Terenty TR, Dick-Smith JB, Walters D. Benign rheumatoid arthritis of the aged. Br Med J. 1974;1:444–6.

    Article  PubMed  CAS  Google Scholar 

  14. van Schaardenburg D, Hazes JM, de Boer A, Zwinderman AH, Meijers KA, Breedveld FC. Outcome of rheumatoid arthritis in relation to age and rheumatoid factor at diagnosis. J Rheumatol. 1993;20:45–52.

    PubMed  Google Scholar 

  15. Wagner U, Kaltenhauser S, Sauer H, Arnold S, Seidel W, Hantzschel H, et al. HLA markers and prediction of clinical course and outcome in rheumatoid arthritis. Arthritis Rheum. 1997;40:341–51.

    Article  PubMed  CAS  Google Scholar 

  16. Chen DY, Hsieh TY, Chen YM, Hsieh CW, Lan JL, Lin FJ. Proinflammatory cytokine profiles of patients with elderly-onset rheumatoid arthritis: a comparison with younger-onset disease. Gerontology. 2009;55(3):250–8.

    Article  PubMed  CAS  Google Scholar 

  17. Yazici Y, Paget SA. Elderly-onset rheumatoid arthritis. Rheum Dis Clin North Am. 2000;26:517–26.

    Article  PubMed  CAS  Google Scholar 

  18. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum. 2002;46:328–46.

    Article  Google Scholar 

  19. Bijlsma JW. Analgesia and the patient with osteoarthritis. Am J Ther. 2002;9:189–97.

    Article  PubMed  Google Scholar 

  20. Rahme E, Marentette MA, Kong SX, Lelorier J. Use of NSAIDs, COX-2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population. Arthritis Rheum. 2002;47:595–602.

    Article  PubMed  CAS  Google Scholar 

  21. Whelton A, White WB, Bello AE, Puma JA, Fort JG. Effects of celecoxib and rofecoxib on blood pressure and edema in patients > or =65 years of age with systemic hypertension and osteoarthritis. Am J Cardiol. 2002;90:959–63.

    Article  PubMed  CAS  Google Scholar 

  22. Bombardier C, Laine L, Reicin A, Shapiro D, Burgos-Vargas R, Davis B, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis: VIGOR study group. N Engl J Med. 2000;343:1520–8.

    Article  PubMed  CAS  Google Scholar 

  23. Alsalameh S, Burian M, Mahr G, Woodcock BG, Geisslinger G. The pharmacological properties and clinical use of valdecoxib: a new cyclo-oxygenase-2-selective inhibitor. Aliment Pharmacol Ther. 2003;17:489–501.

    Article  PubMed  CAS  Google Scholar 

  24. Healey LA, Sheets PK. The relation of polymyalgia rheumatica to rheumatoid arthritis. J Rheumatol. 1988;15:750–2.

    PubMed  CAS  Google Scholar 

  25. Lockie LM, Gomez E, Smith DM. Low dose adrenocorticosteroids in the management of elderly patients with rheumatoid arthritis: selected examples and summary of efficacy in the long-term treatment of 97 patients. Semin Arthritis Rheum. 1983;12:373–81.

    Article  PubMed  CAS  Google Scholar 

  26. van Schaardenburg D, Valkema R, Dijkmans BA, Papapoulos S, Zwinderman AH, Han KH, et al. Prednisone treatment of elderly-onset rheumatoid arthritis. Disease activity and bone mass in comparison with chloroquine treatment. Arthritis Rheum. 1995;38:334–42.

    Article  PubMed  Google Scholar 

  27. Tutuncu Z, Reed G, Kremer J, Kavanaugh A. Do patients with older-onset rheumatoid arthritis receive less aggressive treatment? Ann Rheum Dis. 2006;65:1226–9.

    Article  PubMed  CAS  Google Scholar 

  28. Kremer JM, Genovese MC, Cannon GW, Caldwell JR, Cush JJ, Furst DE, et al. Concomitant leflunomide therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2002;137:726–33.

    PubMed  CAS  Google Scholar 

  29. Pincus T, Marcum SB, Callahan LF. Longterm drug therapy for rheumatoid arthritis in seven rheumatology private practices: II. Second line drugs and prednisone. J Rheumatol. 1992;19:1885–94.

    PubMed  CAS  Google Scholar 

  30. Wolfe F, Hawley DJ, Cathey MA. Termination of slow acting antirheumatic therapy in rheumatoid arthritis: a 14-year prospective evaluation of 1017 consecutive starts. J Rheumatol. 1990;17:994–1002.

    PubMed  CAS  Google Scholar 

  31. Maini R, St Clair EW, Breedveld F, Furst D, Kalden J, Weisman M, et al. Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT study group. Lancet. 1999;354:1932–9.

    Article  PubMed  CAS  Google Scholar 

  32. Moreland LW, Baumgartner SW, Schiff MH, Tindall EA, Fleischmann RM, Weaver AL, et al. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)-Fc fusion protein. N Engl J Med. 1997;337:141–7.

    Article  PubMed  CAS  Google Scholar 

  33. Weisman MH, Moreland LW, Furst DE, Weinblatt ME, Keystone EC, Paulus HE, et al. Efficacy, pharmacokinetic, and safety assessment of adalimumab, a fully human anti-tumor necrosis factor-alpha monoclonal antibody, in adults with rheumatoid arthritis receiving concomitant methotrexate: a pilot study. Clin Ther. 2003;25:1700–21.

    Article  PubMed  CAS  Google Scholar 

  34. Lipsky PE, van der Heijde DM, St Clair EW, Furst DE, Breedveld FC, Kalden JR, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study group. N Engl J Med. 2000;343:1594–602.

    Article  PubMed  CAS  Google Scholar 

  35. Genovese MC, Bathon JM, Martin RW, Fleischmann RM, Tesser JR, Schiff MH, et al. Etanercept versus methotrexate in patients with early rheumatoid arthritis: two-year radiographic and clinical outcomes. Arthritis Rheum. 2002;46:1443–50.

    Article  PubMed  CAS  Google Scholar 

  36. Keystone EC, Kavanaugh AF, Sharp JT, Tannenbaum H, Hua Y, Teoh LS, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial. Arthritis Rheum. 2004;50:1400–11.

    Article  PubMed  CAS  Google Scholar 

  37. Fleischmann RM, Baumgartner SW, Tindall EA, Weaver AL, Moreland LW, Schiff MH, et al. Response to etanercept (Enbrel) in elderly patients with rheumatoid arthritis: a retrospective analysis of clinical trial results. J Rheumatol. 2003;30:691–6.

    PubMed  CAS  Google Scholar 

  38. Bresnihan B, Alvaro-Gracia JM, Cobby M, Doherty M, Domljan Z, Emery P, et al. Treatment of rheumatoid arthritis with recombinant human interleukin-1 receptor antagonist. Arthritis Rheum. 1998;41:2196–204.

    Article  PubMed  CAS  Google Scholar 

  39. Kremer JM, Westhovens R, Leon M, Di Giorgio E, Alten R, Steinfeld S, et al. Treatment of rheumatoid arthritis by selective inhibition of T-cell activation with fusion protein CTLA4Ig. N Engl J Med. 2003;349:1907–15.

    Article  PubMed  CAS  Google Scholar 

  40. Kremer JM, Genant HK, Moreland LW, Russell AS, Emery P, Abud-Mendoza C, et al. Effects of abatacept in patients with methotrexate-resistant active rheumatoid arthritis: a randomized trial. Ann Intern Med. 2006;144:865–76.

    PubMed  CAS  Google Scholar 

  41. Edwards JC, Cambridge G. Sustained improvement in rheumatoid arthritis following a protocol designed to deplete B lymphocytes. Rheumatology. 2001;40:205–11.

    Article  PubMed  CAS  Google Scholar 

  42. Leandro MJ, Edwards JC, Cambridge G. Clinical outcome in 22 patients with rheumatoid arthritis treated with B lymphocyte depletion. Ann Rheum Dis. 2002;61:883–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University of California – San Diego, 9500 Gilman Dr., La Jolla, CA, 9093-0943, USA

    Arthur Kavanaugh

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  1. Venkata Sri Cherukumilli
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  2. Arthur Kavanaugh
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Correspondence to Arthur Kavanaugh .

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Editors and Affiliations

  1. Sanford Health Systems, 32nd Ave S 2400, Fargo, 58103, North Dakota, USA

    Yuri Nakasato

  2. , Department of Internal Medicine, University of Michigan, Zina Pitcher Place 109, Ann Arbor, 48109, Michigan, USA

    Raymond L. Yung

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Cherukumilli, V.S., Kavanaugh, A. (2011). Elderly Onset Rheumatoid Arthritis. In: Nakasato, Y., Yung, R. (eds) Geriatric Rheumatology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5792-4_16

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  • DOI: https://doi.org/10.1007/978-1-4419-5792-4_16

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