Is Elderly-Onset Rheumatoid Arthritis Different From Younger-Onset Rheumatoid Arthritis?

Öz

Objectives: To compare elderly-onset rheumatoid arthritis (EORA) patients with younger-onset rheumatoid arthritis (YORA) patients in terms of sociodemographic, clinical and radiological features, and treatment responses. Materials and Methods: 422 rheumatoid arthritis (RA) patients were evaluated retrospectively. Patients with the age of onset of disease symptoms ≥60 were considered EORA, and those <60 were considered YORA. Sociodemographic characteristics, co-morbid diseases, laboratory values,joint involvement patterns, accompanying extra-articular findings,Simple Erosion Narrowing radiological scores(SENS) and the number of patients meeting the 1987 American College of Rheumatology-Rheumatoid Arthritis(ACR-RA) classification criteria were evaluated at the time of initial diagnosis.The doses of steroids and disease-modifying anti-rheumatic drugs(DMARDs) were recorded. Disease activity score with erythrocyte sedimentation rate (DAS28-ESR) at the beginning and 3rd month of DMARDs treatment were recorded. Results: The frequency of EORA was 8.3%.The frequency of rheumatoid factor positivity(82.9%), co-morbid disease frequency(77.1%) and the mean value of erythrocyte sedimentation rate (62.0±25.21 mm/h) seen in patients with EORA were significantly higher than patients with YORA(55%,%19.9 and 33.97±19.48, respectively)(p<0.05).There was no significant difference between patients with EORA and patients with YORA in terms of the baseline DAS-28-ESR and C-reactive protein mean values,SENS median value,frequency of positive anti-cyclic citrullinated peptide,joint involvement frequency, frequency of meeting 1987 ACR-RA classification criteria, and frequency of steroid and DMARDs usage(p>0.05).There was no difference between the patients with EORA and YORA in terms of DAS28-ESR values measured at the 3rd month of treatment and steroid doses used(p>0.05). Conclusion: There is no difference in many clinical and laboratory findings, especially disease activity scores and radiographic scores, in patients with EORA and YORA.

Anahtar Kelimeler

• Elderly-Onset Rheumatoid Arthritis
• Younger-Onset Rheumatoid Arthritis
• Radiological Scoring

Yaşlı Başlangıçlı Romatoid Artrit, Genç Başlangıçlı Romatoid Artritten Farklı mı?

Öz

Giriş ve Amaç: Yaşlı başlangıçlı romatoid artritli (YBRA) hastaları, genç başlangıçlı romatoid artritli (GBRA) hastalar ile sosyodemografik, klinik, radyolojik ve tedavi yanıtları açısından karşılaştırmaktır. Gereç ve Yöntemler: 2010 American College of Rheumatology-Rheumatoid Arthritis (ACR-RA) sınıflama kriterlerini karşılayan 422 romatoid artrit (RA) hastası geriye dönük olarak değerlendirildi. Hastalık semptomlarının başlangıç yaşı≥60 olan hastalar YBRA, <60 olanlar GBRA olarak kabul edildi. Sosyodemografik özellikler, komorbid hastalıklar, laboratuvar değerleri, eklem tutulum paternleri, eşlik eden eklem dışı bulgular, radyolojik skorlar ve 1987 ACR-RA sınıflama kriterlerini karşılayan hasta sayısı ilk tanı anında belirlendi. Steroid ve hastalık modifiye edici antiromatizmal ilaçların(HMEAİ) dozları kaydedildi. HMEAİ tedavisinin başlangıcında ve 3. ayında hastalık aktivite skoru(DAS28-ESR) incelendi. Bulgular: YBRA sıklığı %8,3 idi. YBRA’li hastalarda romatoid faktör pozitiflik sıklığı (%82.9),komorbid hastalık sıklığı (%77.1) ve eritrosit sedimantasyon hızı ortalama değeri (62.0±25.21 mm/saat) GBRA’li hastalardan anlamlı derecede yüksekti (sırasıyla %55,%19.9 ve 33.97±19.48)(p<0.05). YBRA'lı hastalar ile GBRA'lı hastalar arasında; başlangıç DAS-28-ESR değerleri, C-reaktif protein ortalama değerleri, SENS medyan değeri, anti-siklik sitrüline peptid pozitiflik sıklığı, eklem tutulum patern sıklıkları, 1987 ACR-RA sınıflandırma kriterlerini karşılayan hasta sıklığı ve steroid ile HMEAİ kullanım sıklığı açısından anlamlı farklılık yoktu (p>0.05). Yine YBRA ve GBRA'lı hastalar arasında tedavinin 3. ayında ölçülen DAS28-ESR değerleri ve kullanılan steroid dozları açısından farklılık yoktu (p>0.05). Sonuç: YBRA ve GBRA'lı hastalarda hastalık aktivite skorları ve radyografik skorlar başta olmak üzere birçok klinik ve laboratuvar bulgu arasında farklılık yoktur.

Anahtar Kelimeler

• Genç Başlangıçlı Romatoid Artrit
• Yaşlı Başlangıçlı Romatoid Artrit
• Radyolojik Skorlama

Kaynakça

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