FRI0054 CHARACTERISTICS OF PATIENTS WITH ELDERLY-ONSET RHEUMATOID ARTHRITIS AND INVESTIGATION OF DRUG THERAPY

Background It is expected that the increase in average life expectancy in recent years would also be observed even in patients with rheumatoid arthritis (RA) Objectives We compared data for RA patients obtained between 1991 and 2018 to clarify the current clinical picture of RA in elderly patients. Methods We evaluated 429 and 368 RA cases seen at our department in 1991 and 2018, respectively. The patient ages and sex ratios in the two groups were first compared, and then the clinical features of 260 patients with younger-onset RA (YORA; onset age 65 years) in the 2018 group were evaluated. All patients satisfied the 1987 and 2010 Rheumatoid arthritis classification criteria for RA, and their data were obtained from the medical records. Patient data at the onset of RA were used. The study protocol was approved by the Institutional Review Board of Niigata University. All statistical analyses were performed with SPSS ver. 13 for Windows, and differences at p Results The peak age at RA onset was 50s-60s in 1991 and 60s-70s in 2018. In 1991, the male-female ratios in the 65-yr age groups were 0.14 and 0.19, respectively, whereas the corresponding ratios in 2018 were 0.25 and 0.38, respectively. Although the proportion of elderly patients increased, homogeneity testing of the odds ratio revealed no significant difference. Among the 368 RA patients in the 2018 group, initial involvement of large joints was more frequent in those with EORA, whereas initial involvement of small joints was more frequent in those with YORA (p 1.0 g/Cr) showed no inter-group differences. The frequency of RF positivity also did not differ between the groups, but the RF titer was higher in the YORA group (p 60 years. For therapy, MTX was used in about 70% of YORA patients, its use being more frequent than EORA patients (p Conclusion The characteristics of EORA patients differ from those of YORA patients. Diagnosis requires attention to PMR. In YORA, attention to amyloid is also required in view of the fact that treatment was insufficient in the past. Pharmacotherapy should be based on the characteristics of aging in elderly patients with RA. The diagnosis and treatment of RA in elderly patients is an issue of future concern. Reference [1] Sugihara T, et, al. Structural and functional outcomes of a therapeutic strategy targeting low disease activity in patients with elderly-onset rheumatoid arthritis: a prospective cohort study (CRANE). Rheumatology (Oxford). 2015;54:798-807. Disclosure of Interests None declared