AUTHOR=Mena-Vázquez Natalia , Lisbona-Montañez Jose Manuel , Redondo-Rodriguez Rocío , Mucientes Arkaitz , Manrique-Arija Sara , Rioja José , Garcia-Studer Aimara , Ortiz-Márquez Fernando , Cano-García Laura , Fernández-Nebro Antonio 

TITLE=Inflammatory profile of incident cases of late-onset compared with young-onset rheumatoid arthritis: A nested cohort study

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1016159

DOI=10.3389/fmed.2022.1016159

ISSN=2296-858X

ABSTRACT=<sec><title>Objectives</title><p>To describe the characteristics of patients between late-onset rheumatoid arthritis (LORA) with young-onset (YORA), and analyze their association with cumulative inflammatory burden.</p></sec><sec><title>Methods</title><p>We performed a nested cohort study in a prospective cohort comprising 110 patients with rheumatoid arthritis (RA) and 110 age- and sex-matched controls. The main variable was cumulative inflammatory activity according to the 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR). High activity was defined as DAS28 ≥ 3.2 and low activity as DAS28 &lt; 3.2. The other variables recorded were inflammatory cytokines, physical function, and comorbid conditions. Two multivariate models were run to identify factors associated with cumulative inflammatory activity.</p></sec><sec><title>Results</title><p>A total of 22/110 patients (20%) met the criteria for LORA (≥ 60 years). Patients with LORA more frequently had comorbid conditions than patients with YORA and controls. Compared with YORA patients, more LORA patients had cumulative high inflammatory activity from onset [13 (59%) vs. 28 (31%); <italic>p</italic> = 0.018] and high values for CRP (<italic>p</italic> = 0.039) and IL-6 (<italic>p</italic> = 0.045). Cumulative high inflammatory activity in patients with RA was associated with LORA [OR (95% CI) 4.69 (1.49–10.71); <italic>p</italic> = 0.008], smoking [OR (95% CI) 2.07 (1.13–3.78); <italic>p</italic> = 0.017], anti–citrullinated peptide antibody [OR (95% CI) 3.24 (1.15–9.13); <italic>p</italic> = 0.025], average Health Assessment Questionnaire (HAQ) score [OR (95% CI) 2.09 (1.03–14.23); <italic>p</italic> = 0.034], and physical activity [OR (95% CI) 0.99 (0.99–0.99); <italic>p</italic> = 0.010]. The second model revealed similar associations with inflammatory activity in patients with LORA.</p></sec><sec><title>Conclusion</title><p>Control of inflammation after diagnosis is poorer and comorbidity more frequent in patients with LORA than in YORA patients and healthy controls.</p></sec>