Targeting Low Disease Activity in Elderly-Onset Rheumatoid Arthritis: Current and Future Roles of Biological Disease-Modifying Antirheumatic Drugs

摘要: Elderly rheumatoid arthritis (RA) is classified into two clinical subsets, elderly-onset RA (EORA) and younger-onset elderly RA. With the improvement of life expectancy in general population advent super-aging society, number patients with EORA anticipated to increase. Both large small joints are affected initially at onset, individuals early have higher scores disease activity levels acute-phase reactants than those a progressive similar Tumor necrosis factor (TNF) inhibitors equally or slightly less effective younger RA, duration may greater impact on outcomes age. Evidence non-TNF biological disease-modifying antirheumatic drug use limited. TNF not increase risk for infection any more methotrexate; however, increasing age an independent strong serious infections Treatment choice strongly influenced by comorbidities, especially cardiovascular disease, chronic lung frailty. To prevent progression irreversible geriatric syndromes, non-frail EORA, who aging successfully should undergo intensive treatment using treat-to-target strategy, pre-frail frail be treated aim returning stage, respectively. An appropriate strategy developed next decade multi-disciplinary approach.