| Management issues with elderly-onset rheumatoid arthritis: an update. | |
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MedLine Citation:
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PMID: 16245956 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Elderly-onset rheumatoid arthritis (EORA) is defined as rheumatoid arthritis (RA) starting at >60 years of age. EORA is characterised by a lower female/male ratio compared with RA in younger patients and it more frequently has an acute onset accompanied by constitutional symptoms. Two incompletely overlapping subsets of RA have been recognised: one exhibits the classical RA clinical picture while the other has a polymyalgia rheumatica-like appearance, characterised by shoulder involvement, absence of rheumatoid factor and, usually, by a nonerosive course. Identification of anti-cyclic citrullinated peptide antibodies is useful for distinguishing the latter subset from true polymyalgia rheumatica. Elderly-onset spondyloarthritis, crystal-related arthritis, remitting seronegative symmetrical synovitis with pitting oedema syndrome and hepatitis C virus-related arthritis must also be considered in the differential diagnosis. EORA treatment requires prudence because of the increase in age-related risks pertaining principally to the renal, cardiovascular and gastrointestinal systems. No groups of molecules usually employed for RA therapy in younger subjects (analgesics, NSAIDs, corticosteroids, disease-modifying antirheumatic drugs, anticytokine drugs) can be excluded a priori from the treatment of EORA patients. Nevertheless, the risk/benefit ratio relating to their use must be accurately evaluated for every single patient. Recently marketed compounds such as leflunomide and tumour necrosis factor-alpha antagonists have also increased the therapeutic opportunities for aged RA patients. |
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Authors:
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Ignazio Olivieri; Carlo Palazzi; Giovanni Peruz; Angela Padula |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Drugs & aging Volume: 22 ISSN: 1170-229X ISO Abbreviation: Drugs Aging Publication Date: 2005 |
Date Detail:
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Created Date: 2005-10-25 Completed Date: 2006-01-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102074 Medline TA: Drugs Aging Country: New Zealand |
Other Details:
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Languages: eng Pagination: 809-22 Citation Subset: IM |
Affiliation:
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Rheumatology Department of Lucania, Matera and Potenza: S. Carlo Hospital of Potenza, Chieti, Italy. ignazioolivieri@tiscalinet.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aging* / drug effects Antirheumatic Agents / administration & dosage, adverse effects, therapeutic use* Arthritis, Rheumatoid* / diagnosis, drug therapy, epidemiology Diagnosis, Differential Humans |
| Chemical | |
Reg. No./Substance:
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0/Antirheumatic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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