International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation.
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История · было → стало
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Hammam Nevin, El-Hadidi Tahsin, El-Hadidi Khaled, Elsaman Ahmed, El-Bakry Samah A, Nassr Maha, El-Saadany Hanan M, Mosad Doaa, Nasef Samah I, Selim Zahraa I, Samy Nermeen, Moshrif Abdelhfeez, Taha Hanan, Fawzy Rasha M, Al-Adle Suzan S, Ibrahim Amira M, Elsaid Nora Y, Tharwat Samar, Gamal Nada M, Ibrahim Maha E, Senara Soha, Shereef Rawhya El, Amer Marwa A, Ismail Faten, Elazeem Mervat I Abd, Abaza Nouran M, Mohamed Eman F, El-Essawi Dina F, Elzokm Saad M, Fawzy Samar M, Eesa Nahla N, Abdelaleem Enas A, Abdalla Ahmed M, Fathi Hanan M, El-Eishi Hatem H, Sayed Safaa, Mohammed Reem Hamdy A, Gheita Tamer A
Аннотация
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. Key Points • Juvenile-onset and elderly-onset RA patients have notable differences compared to the adult-onset cases. • Co-morbidities and certain manifestations, including cardiovascular disease and hypothyroidism, as well as higher disease activity and functional disability, are more common in elderly-onset patients. • Fibromyalgia remains more frequent in adult-onset cases.