Abstract Objectives To investigate whether clinical outcomes and patient reported outcomes (PROs) differ over 2 years based on the age of onset of rheumatoid arthritis (RA). Methods All RA patients from the tREACH trial, a multicenter, stratified, single-blinded trial with a treat-to-target management approach and a fixed medication protocol were included. The age of disease onset was categorized into young-onset RA (YORA) (45 years, n = 119); middle-aged onset RA (MORA) (45–65 years, n = 208); and elderly-onset RA (EORA) (65 years, n = 98) at the time of diagnosis. Mixed models were used to compare clinical outcomes and PROs over time. The following PROs were included: pain (Numeric Rating Scale), fatigue (Visual Analogue Scale), functional ability (HAQ-DI), quality of life (EQ-5D-3L) and possible depression (HADS-D) or anxiety disorder (HADS-A). Results At diagnosis, EORA patients had more swollen joints, erosions and comorbidities than younger patients. However, disease activity remained similar across age groups at diagnosis and over time. After 2 years of follow-up, bDMARD usage was 30%, 30%, and 15% in YORA, MORA, and EORA patients, respectively. EORA patients also experienced less pain and fatigue over time compared to YORA patients (1 (95%CI: 0.5–1.6) and 17.3 mm (11.3–23.4) lower) and MORA patients (0.6 (0.1–1) and 5.8 mm (0.7–10.9) lower). No other clinically relevant PRO differences were observed. Conclusion Despite unfavorable prognostic factors at diagnosis, EORA patients have similar outcomes compared to their younger counterparts if a treat-to-target management approach is applied. Notably, fewer EORA patients required bDMARDs to reach the same treatment target.
Dağ et al. (Sat,) studied this question.