International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation

被引：2

作者：

Hammam, Nevin ^{[1
]}

El-Hadidi, Tahsin ^{[2
]}

El-Hadidi, Khaled ^{[3
]}

Elsaman, Ahmed ^{[4
]}

El-Bakry, Samah A. ^{[5
]}

Nassr, Maha ^{[6
]}

El-Saadany, Hanan M. ^{[7
]}

Mosad, Doaa ^{[8
]}

Nasef, Samah I. ^{[9
]}

Selim, Zahraa I. ^{[1
]}

Samy, Nermeen ^{[5
]}

Moshrif, Abdelhfeez ^{[10
]}

Taha, Hanan ^{[11
]}

Fawzy, Rasha M. ^{[12
]}

Al-Adle, Suzan S. ^{[3
]}

Ibrahim, Amira M. ^{[13
]}

Elsaid, Nora Y. ^{[3
]}

Tharwat, Samar ^{[14
]}

Gamal, Nada M. ^{[1
]}

Ibrahim, Maha E. ^{[9
]}

Senara, Soha ^{[6
]}

Shereef, Rawhya El ^{[15
]}

Amer, Marwa A. ^{[16
]}

Ismail, Faten ^{[15
]}

Elazeem, Mervat I. Abd ^{[17
]}

Abaza, Nouran M. ^{[18
]}

Mohamed, Eman F. ^{[19
]}

El-Essawi, Dina F. ^{[20
]}

Elzokm, Saad M. ^{[21
]}

Fawzy, Samar M. ^{[3
]}

Eesa, Nahla N. ^{[3
]}

Abdelaleem, Enas A. ^{[17
]}

Abdalla, Ahmed M. ^{[22
]}

Fathi, Hanan M. ^{[6
]}

El-Eishi, Hatem H. ^{[3
]}

Sayed, Safaa ^{[3
]}

Mohammed, Reem Hamdy A. ^{[3
]}

Gheita, Tamer A. ^{[3
]}

机构：

[1] Assiut Univ, Fac Med, Rheumatol Dept, Assiut, Egypt

[2] Mil Acad, Agouza Rheumatol Ctr, Rheumatol Dept, Giza, Egypt

[3] Cairo Univ, Fac Med, Rheumatol Dept, Cairo, Egypt

[4] Sohag Univ, Fac Med, Rheumatol Dept, Sohag, Egypt

[5] Ain Shams Univ, Fac Med, Internal Med Dept, Rheumatol Unit, Cairo, Egypt

[6] Fayoum Univ, Fac Med, Rheumatol Dept, Al Fayyum, Egypt

[7] Tanta Univ, Fac Med, Rheumatol Dept, Gharbia, Egypt

[8] Mansoura Univ, Fac Med, Rheumatol Dept, Dakahlia, Egypt

[9] Suez Canal Univ, Fac Med, Rheumatol Dept, Ismailia, Egypt

[10] Al Azhar Univ, Fac Med, Rheumatol Dept, Assiut, Egypt

[11] Beni Suef Univ, Fac Med, Internal Med Dept, Rheumatol Unit, Bani Suwayf, Egypt

[12] Benha Univ, Fac Med, Rheumatol Dept, Kalyoubia, Egypt

[13] Kafr El Sheikh Univ, Fac Med, Dept Pediat, Kafr Al Sheikh, Egypt

[14] Mansoura Univ, Fac Med, Internal Med Dept, Rheumatol & Immunol Unit, Dakahlia, Egypt

[15] Minia Univ, Fac Med, Rheumatol Dept, Al Minya, Egypt

[16] Alexandria Univ, Fac Med, Rheumatol Dept, Alexandria, Egypt

[17] Beni Suef Univ, Fac Med, Rheumatol Dept, Bani Suwayf, Egypt

[18] Ain Shams Univ, Fac Med, Rheumatol Dept, Cairo, Egypt

[19] Al Azhar Univ, Fac Med Girls, Internal Med Dept, Rheumatol Unit, Cairo, Egypt

[20] Egyptian Atom Energy Author EAEA, Internal Med Dept, Rheumatol Unit NCRRT, Cairo, Egypt

[21] Al Azhar Univ, Fac Med, Rheumatol Dept, Damiette, Egypt

[22] Damietta Univ, Fac Med, Rheumatol & Rehabil Dept, Dumyat, Egypt

来源：

CLINICAL RHEUMATOLOGY | 2025年 / 44卷 / 03期

关键词：

Adult-onset; Comorbidities; DAS28; Elderly-onset; Juvenile-onset; Rheumatoid arthritis; CLASSIFICATION CRITERIA; IDIOPATHIC ARTHRITIS; YOUNG;

D O I：

10.1007/s10067-025-07356-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Elderly-onset rheumatoid arthritis (EORA) may have peculiar findings compared to juvenile-onset RA (JORA). The aim of the work was to present and compare the clinical characteristics of RA patients with JORA and elderly-onset EORA to a group of cases with adult-onset (AORA) and to contrast the findings worldwide. Methods The study included 1100 adult RA patients: 209 JORA and 329 EORA, compared with 562 AORA extracted from a big data national study on 10,364 RA patients. Clinical characteristics, laboratory investigations, medications received, and co-morbidities were recorded. The disease activity index (DAS28) and health assessment questionnaire (HAQ) were estimated. Results The JORA cases represented 19% and EORA 29.9% of the included cohort. The mean age at onset for JORA, EORA, and AORA were 15.1 +/- 2.1, 64 +/- 4.2, and 36.4 +/- 10 years (p < 0.0001), and the female-male ratio was 6.2:1, 2.7:1, and 7.3:1 (p < 0.0001), respectively. In EORA, body mass index (28.8 +/- 5.8) and frequencies of smokers (11.6%), diabetes (12.2%), hypertension (19.8%), and osteoporosis (5.2%) were significantly higher than in JORA (26.02 +/- 5; 5.3%, 2.9%, 3.8%, and 1%) and AORA (27.6 +/- 5.6; 3%, 8.4%, 14.9%, and 2.3%, p = 0.016) (p < 0.0001, p = 0.001, p < 0.0001, and p = 0.009, respectively). In JORA, oral ulcers were significantly more frequent (p = 0.04); in EORA, cardiovascular manifestations (p < 0.0001) and hypothyroidism (p = 0.039) were more frequent; and DAS28 (p = 0.01) and HAQ (p = 0.038) were higher. Fibromyalgia and methotrexate administration were significantly more frequent in AORA (p < 0.0001 and p = 0.04, respectively). Rheumatoid factor, anti-cyclic citrullinated peptide, and double seropositivity were significantly more frequent in EORA (p < 0.0001, p = 0.008, and p = 0.002, respectively). Conclusion Comorbidities, cardiovascular manifestations, hypothyroidism, higher disease activity, and functional disability are more common in EORA patients.

引用

页码：979 / 988

页数：10

共 43 条

[1] Disease Factors in Early Rheumatoid Arthritis Are Associated with Differential Risks for Cardiovascular Events and Mortality Depending on Age at Onset: A 10-year Observational Cohort Study [J].