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

Yıl 2022, , 243 - 250, 30.06.2022

Yunus Durmaz , İlker İlhanlı , Betul Ustun Cetinkaya Kıvanç Cengiz

https://doi.org/10.34087/cbusbed.1032757

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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