The older rheumatoid arthritis patients: who are they and how should they be treated?

Abstract

Differences in clinical characteristics of older and younger rheumatoid arthritis (RA) patients have led some researchers to believe that RA in older patients is a distinct clinical entity and requires specialized therapeutic management. Whether or not there are any differences in clinical features and prognosis between older and younger RA patients, there is general consensus that RA should be treated aggressively early in the course of the disease to achieve the best clinical outcome. For this reason, all patients, irrespective of age, are treated with commonly used disease-modifying antirheumatic drugs/biologic agents. Although the data are limited, published safety and efficacy papers on older RA patients suggest that most disease-modifying antirheumatic drugs/biologic agents have similar efficacy and safety outcomes to younger RA patients. However, due to multiple comorbidities, older RA patients may be at a higher risk for adverse drug reactions.