Age at onset determines severity and choice of treatment in early rheumatoid arthritis: a prospective study

作者：Lena Innala, Ewa H. Berglin, Bozena Möller, Lotta Ljung, Torgny Smedby, Anna Södergren, Staffan Magnusson, Solbritt Rantapää‐Dahlqvist, Solveig Wållberg‐Jonsson · 发表于：Arthritis Research & Therapy · 年份：2014 · 被引用次数：173 · 研究领域：Rheumatoid Arthritis Research and Therapies、Systemic Lupus Erythematosus Research、Spondyloarthritis Studies and Treatments

INTRODUCTION: Disease activity, severity and comorbidity contribute to increased mortality in patients with rheumatoid arthritis (RA). We evaluated the impact of age at disease onset on prognostic risk factors and treatment in patients with early disease. METHODS: In this study, 950 RA patients were followed regularly from the time of inclusion (<12 months from symptom onset) for disease activity (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tender and/or swollen joints, Visual Analogue Scale pain and global scores, and Disease Activity Score in 28 joints (DAS28)) and function (Health Assessment Questionnaire (HAQ)). Disease severity, measured on the basis of radiographs of the hands and feet (erosions based on Larsen score), extraarticular disease, nodules, and comorbidities and treatment (disease-modifying antirheumatic drugs (DMARDs), corticosteroids, biologics and nonsteroidal anti-inflammatory drugs) were recorded at the time of inclusion and at 5 years. Autoantibodies (rheumatoid factor, antinuclear antibodies and antibodies against cyclic citrullinated peptides (ACPAs)) and genetic markers (human leucocyte antibody (HLA) shared epitope and protein tyrosine phosphatase nonreceptor type 22 (PTPN22)) were analysed at the time of inclusion. Data were stratified as young-onset RA (YORA) and late-onset RA (LORA), which were defined as being below or above the median age at the time of onset of RA (58 years). RESULTS: LORA was associated with lower frequenc...