Reumatizam, Vol. 63 No. 1, 2016.
Professional paper
REUMATOIDNI ARTRITIS KASNOG NASTUPA: OPSERVACIJSKA STUDIJA
Sylejman Rexhepi
Mjellma Rexhepi
Vjollca Sahatçiu-Meka
Blerta Rexhepi
Elton Bahtiri
Vigan Mahmutaj
Abstract
Rheumatoid arthritis (RA) may have an onset at older age. Th e onset of the disease at the age of 60 and
over is called late-onset rheumatoid arthritis (LORA). Th e aim of this study was to analyze the clinical, laboratory,
radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA),
provided that all the patients had an approximately equal duration of the disease. Th is is an observational single-center
study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients
EaORA. Th e disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was signifi cantly higher in the
LORA group compared to the EaORA group (p<0.05). Signifi cantly more patients with LORA had involvement of the
shoulders (LORA vs. EaORA, 30% vs. 15%; p <0.05) and knees (LORA vs. EaORA, 46.7% vs. 16.7%; p <0.05). Radiological
erosive changes were signifi cantly more frequent in the LORA group in comparison with EaORA (p <0.05).
Th ere was no diff erence between the groups regarding rheumatoid factor (RF) positivity (p>0.05), while the number
of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group
(p<0.05). Th e values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were signifi cantly higher
in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in
the EaORA group (12.18±1.56 g/dL). Th e most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate
and sulfasalazine, while biological drugs were not used.
In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as
higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. Th is
should be taken in account in clinical practice, especially regarding treatment choices.
Keywords
Arthritis, rheumatoid – epidemiology, physiopathology; Radiography, drug therapy; Rheumatoid factor – blood; Autoantibodies – blood; Peptides, cyclic – immunology; C-reactive protein – analysis; Joints – pathology; Antirheumatic agents – therapeutic use; Age of onset; Severity of illness index
Hrčak ID:
182800
URI
Publication date:
10.5.2016.
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