ReviewElderly-onset rheumatoid arthritis
Section snippets
Treatment of elderly-onset rheumatoid arthritis
The treatment of elderly-onset rheumatoid arthritis pursues the same objectives as in younger patients: to control the clinical manifestations, to prevent structural damage, to preserve function, and to decrease excess mortality. In the elderly, the presence of co-morbidities and increased rate of drug adverse effects raise specific therapeutic challenges.
The relevance of the DAS for monitoring the course of EORA has been called into question because advancing age is associated with elevation
Methotrexate
The pharmacokinetics of intramuscular methotrexate was studied in 38 patients aged 65 to 83 years comparatively to 24 patients aged 21 to 45 years [37]. Pharmacokinetic parameters correlated with creatinine clearance but not with age. The possible influence of NSAIDs on methotrexate clearance remains controversial. Whereas no clinically relevant influence occurs in younger patients, older patients on combined methotrexate and NSAIDs therapy should be carefully monitored given the impact of
Cardiovascular risk management in elderly-onset rheumatoid arthritis
There is conclusive evidence that RA is associated with an increase in cardiovascular risk. In RA patients, the risk of cardiovascular events is increased 2-fold, independently from conventional cardiovascular risk factors [58]. This risk increase is directly and indirectly mediated by systemic inflammation. Strict disease control with methotrexate or TNFα antagonist therapy may decrease the cardiovascular morbidity and mortality rates [58].
A single study specifically evaluated the effect of
Conflicts of interest
None of the authors has any conflicts of interest to declare.
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2019, Seminars in Arthritis and RheumatismCitation Excerpt :A detailed search strategy is included in supplementary file S1. References of all the included articles and review articles were used to hand-search additional studies [2,32,33,36,37]. A PRISMA checklist has been attached as a supplementary file S2 [38].
In vivo exposure to hydroquinone during the early phase of collagen-induced arthritis aggravates the disease
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