Rheumatoid arthritis in the elderly. Prevalence and optimal management.
Elderly-onset rheumatoid arthritis (EORA), defined as rheumatoid arthritis (RA) with onset at age 60 years or over, differs slightly from younger-onset RA by a more equal gender distribution, a higher frequency of acute systemic onset with involvement of the shoulder, a higher disease activity, and, in later stages, more radiographic damage and functional decline. Several subsets of EORA are recognised, such as rheumatoid factor-positive RA, polymyalgia rheumatica and 'remitting seronegative symmetrical synovitis with pitting oedema'. These conditions can be difficult to distinguish from crystal-induced arthritis, osteoarthritis and paraneoplastic arthritis. The efficacy and tolerability of second-line drugs is similar in both age groups, but in the elderly caution is needed with the use of nonsteroidal anti-inflammatory drugs and prednisone.
van Schaardenburg
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Rheumatology Clinic, Jan van Breemen Institute, Amsterdam, The Netherlands.
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000375:Aging / Q000473:pathology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005081:Exercise Therapy; D006801:Humans; D015995:Prevalence; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents