A NEW study has revealed that patients with late-onset rheumatoid arthritis (LORA), diagnosed at age 65 or older, face poorer functional outcomes and a higher risk of adverse events compared to younger-onset rheumatoid arthritis (YORA) patients.
The study analysed data from the IORRA cohort (2000–2016), focusing on 3,270 patients with early rheumatoid arthritis (disease duration < 2 years). Patients were categorised as LORA (n = 813, median age 71) and YORA (n = 2,457, median age 51).
While both groups experienced significant initial improvements in disease activity (Clinical Disease Activity Index, CDAI), long-term physical function, measured via the Health Assessment Questionnaire (J-HAQ), showed disparities. By Year 5, J-HAQ scores worsened progressively for LORA patients (0.56) compared to YORA patients, who maintained scores below 0.5 (0.33 at Year 5).
Additionally, LORA patients had a higher incidence of adverse events, including death (adjusted hazard ratio 4.70) and malignancy (adjusted hazard ratio 2.58). LORA patients were also less likely to receive methotrexate (70.6% vs. 81.6%) and biological DMARDs (8.4% vs. 19.4%).
“These findings highlight the unique challenges faced by older rheumatoid arthritis patients, including higher risks of functional decline and adverse events,” the authors stated.
The study underscores the importance of tailored treatment strategies for late-onset rheumatoid arthritis to improve long-term outcomes and minimise risks in this vulnerable patient population.
Aleksandra Zurowska, EMJ
Reference
Sugitani N et al. Higher risk of poor functional outcome and unfavorable clinical events for late-onset rheumatoid arthritis: results from the IORRA cohort. Rheumatology. 2024;DOI: 10.1093/rheumatology/keae673.
