Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

Jenny Nilsson,1 Maria LE Andersson,2,3 Ingiäld Hafström,4 Björn Svensson,2 Kristina Forslind,2,3 Sofia Ajeganova,4,5 Monica Leu Agelii,1,* Inger Gjertsson1,* 1Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg Unive...

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Autores principales:	Nilsson J, Andersson MLE, Hafstrom I, Svensson B, Forslind K, Ajeganova S, Leu Agelii M, Gjertsson I
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	rheumatoid arthritis disease course treatment age- and sex-dependent differences Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/0837c09613b74712852ba1d342b3d8e2
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spelling	oai:doaj.org-article:0837c09613b74712852ba1d342b3d8e22021-12-02T14:57:41ZInfluence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis1179-156Xhttps://doaj.org/article/0837c09613b74712852ba1d342b3d8e22021-05-01T00:00:00Zhttps://www.dovepress.com/influence-of-age-and-sex-on-disease-course-and-treatment-in-rheumatoid-peer-reviewed-fulltext-article-OARRRhttps://doaj.org/toc/1179-156XJenny Nilsson,1 Maria LE Andersson,2,3 Ingiäld Hafström,4 Björn Svensson,2 Kristina Forslind,2,3 Sofia Ajeganova,4,5 Monica Leu Agelii,1,* Inger Gjertsson1,* 1Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; 2Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; 3Spenshult Research and Development Center, Halmstad, Sweden; 4Division of Gastroenterology and Rheumatology, Department of Medicine Huddinge, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; 5Department of Clinical Sciences, Rheumatology Division. Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium*These authors contributed equally to this workCorrespondence: Monica Leu AgeliiDepartment of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Box 480, Gothenburg, 40530, SwedenTel +46- 31-342 4692Email monica.leu@gu.seObjective: More than 50% of patients with rheumatoid arthritis (RA) are > 65 years at diagnosis. Age of onset and sex may influence the disease course, outcome and treatment. This study follows a large cohort of patients with early RA to assess contributions of age and sex to disease outcomes.Methods: Patients from the BARFOT cohort, n=2837 (68% women), were followed for eight years at predefined time points to assess inflammation, function, joint destruction and treatment with disease modifying anti-rheumatic drugs (DMARDs) and glucocorticoids (GC). The patients were divided by sex and age at inclusion (< 40, 40– 54, 55– 69 and ≥ 70 years).Results: For both sexes, disease activity, function and pain improved over time, significantly more in men than in women in all age groups. In men, those < 40 years displayed significantly lower DAS28 compared with all other groups. This group was also the least represented group in the study. The Sharp van der Heijde Score (SHS) increased over time in both sexes and all age groups. Women ≥ 70 years showed less improvement in disability and the highest progression of SHS mainly due to increased joint space narrowing. Patients < 40 years were more likely to receive biological DMARDs, while those ≥ 70 years more often received only GC treatment.Conclusion: There were significant age- and sex-dependent differences in the medical treatment and in outcome of RA 8 years after diagnosis. The differences were most pronounced in men< 40 and women ≥ 70 years, but whether they are due to disease phenotype or treatment is unclear.Keywords: rheumatoid arthritis, disease course, treatment, age- and sex-dependent differencesNilsson JAndersson MLEHafstrom ISvensson BForslind KAjeganova SLeu Agelii MGjertsson IDove Medical Pressarticlerheumatoid arthritisdisease coursetreatmentage- and sex-dependent differencesDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 13, Pp 123-138 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis disease course treatment age- and sex-dependent differences Diseases of the musculoskeletal system RC925-935
spellingShingle	rheumatoid arthritis disease course treatment age- and sex-dependent differences Diseases of the musculoskeletal system RC925-935 Nilsson J Andersson MLE Hafstrom I Svensson B Forslind K Ajeganova S Leu Agelii M Gjertsson I Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
description	Jenny Nilsson,1 Maria LE Andersson,2,3 Ingiäld Hafström,4 Björn Svensson,2 Kristina Forslind,2,3 Sofia Ajeganova,4,5 Monica Leu Agelii,1,* Inger Gjertsson1,* 1Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; 2Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; 3Spenshult Research and Development Center, Halmstad, Sweden; 4Division of Gastroenterology and Rheumatology, Department of Medicine Huddinge, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; 5Department of Clinical Sciences, Rheumatology Division. Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium*These authors contributed equally to this workCorrespondence: Monica Leu AgeliiDepartment of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Box 480, Gothenburg, 40530, SwedenTel +46- 31-342 4692Email monica.leu@gu.seObjective: More than 50% of patients with rheumatoid arthritis (RA) are > 65 years at diagnosis. Age of onset and sex may influence the disease course, outcome and treatment. This study follows a large cohort of patients with early RA to assess contributions of age and sex to disease outcomes.Methods: Patients from the BARFOT cohort, n=2837 (68% women), were followed for eight years at predefined time points to assess inflammation, function, joint destruction and treatment with disease modifying anti-rheumatic drugs (DMARDs) and glucocorticoids (GC). The patients were divided by sex and age at inclusion (< 40, 40– 54, 55– 69 and ≥ 70 years).Results: For both sexes, disease activity, function and pain improved over time, significantly more in men than in women in all age groups. In men, those < 40 years displayed significantly lower DAS28 compared with all other groups. This group was also the least represented group in the study. The Sharp van der Heijde Score (SHS) increased over time in both sexes and all age groups. Women ≥ 70 years showed less improvement in disability and the highest progression of SHS mainly due to increased joint space narrowing. Patients < 40 years were more likely to receive biological DMARDs, while those ≥ 70 years more often received only GC treatment.Conclusion: There were significant age- and sex-dependent differences in the medical treatment and in outcome of RA 8 years after diagnosis. The differences were most pronounced in men< 40 and women ≥ 70 years, but whether they are due to disease phenotype or treatment is unclear.Keywords: rheumatoid arthritis, disease course, treatment, age- and sex-dependent differences
format	article
author	Nilsson J Andersson MLE Hafstrom I Svensson B Forslind K Ajeganova S Leu Agelii M Gjertsson I
author_facet	Nilsson J Andersson MLE Hafstrom I Svensson B Forslind K Ajeganova S Leu Agelii M Gjertsson I
author_sort	Nilsson J
title	Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
title_short	Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
title_full	Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
title_fullStr	Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
title_full_unstemmed	Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis
title_sort	influence of age and sex on disease course and treatment in rheumatoid arthritis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/0837c09613b74712852ba1d342b3d8e2
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Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis

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