2021 Volume 33 Issue 2 Pages 106-112
Objectives: We compared data for rheumatoid arthritis（RA）patients obtained between 1991 and 2018 to clarify the current clinical picture of RA in elderly patients.
Methods: RA cases seen at our department in 1991 and 2018 were evaluated. The patient ages and sex ratios in the two groups were compared, and the clinical features of patients with younger-onset RA（YORA; onset age <65 years）and patients with elderly-onset RA（EORA; onset age ≥ 65 years）in the 2018 group were evaluated.
Results: We evaluated 429 and 368 RA cases seen at our department in 1991 and 2018, respectively. The clinical features of 260 patients with younger-onset RA（YORA; onset age <65 years）and 108 patients with elderly-onset RA（EORA; onset age ≥ 65 years）in the 2018 group were evaluated. 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 and ≥ 65-yr age groups were 0.14 and 0.19, respectively, whereas the corresponding ratios in 2018 were 0.25 and 0.38, respectively. The frequencies of RF-positive and ACPA-positive patients with, YORA were both higher than those with EORA（P<0.05）. Among other features after diagnosis, AA amyloidosis was observed in only 6（1.6%）of the RA patients. MTX were used in 64% of YORA patients and 33% of EORA patients, the difference being significant（p<0.001）. Biological agents were used in 38% of YORA patients and 22% of EORA patients, the difference being significant（p<0.01）.
Conclusion: The characteristics of EORA patients differ from those of YORA patients. 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.
