Fiehn C, Kessler S
Rheumazentrum Baden-Baden GmbH, Rotenbachtalstr. 5, 76530, Baden-Baden.
Z Rheumatol. 2009 Feb;68(1):69-74. doi: 10.1007/s00393-008-0413-3.
With increasing age DMARD and TNF-alpha-Inhibitors are less frequently used. The goal of this work was to investigate whether the therapeutic response in elderly patients with rheumatoid arthritis (RA) is diminished.
In total, 192 patients admitted to hospital because of active RA were prospectively studied. The improvements in disease activity (RADAI), pain and function (FFbH) three months after release were measured and compared between two age groups.
Patients <65 and > or =65 years of age (n=104 and 88, mean age of 52+/-10 and 72+/-5.6 years, respectively) showed comparable improvements of disease activity and pain in the complete group as well as in those who received newly administered DMARD or TNF-alpha-inhibitors (71.2% and 62.6%, respectively, for the two groups). A significant difference was demonstrated for the change in function: While patients <65 years of age in the mean had a moderate improvement of the FFbH, this could not be shown for the older patients (p=0.04). A close correlation of the improvements of RADAI and FFbH could be shown for the younger patients only.
DMARD or TNF-alpha-inhibitors improve disease activity and pain in elderly patients with RA no less than in younger patients. However, in contrast to the younger patients, the older patients profit less in terms of functional impairment.
随着年龄增长，改善病情抗风湿药（DMARD）和肿瘤坏死因子-α抑制剂（TNF-α抑制剂）的使用频率降低。本研究旨在调查老年类风湿关节炎（RA）患者的治疗反应是否减弱。
前瞻性研究了192例因活动性RA入院的患者。测量并比较了两个年龄组出院三个月后疾病活动度（类风湿关节炎疾病活动指数，RADAI）、疼痛和功能（健康评估问卷功能指数，FFbH）的改善情况。
年龄＜65岁和≥65岁的患者（分别为n = 104和88，平均年龄分别为52±10岁和72±5.6岁）在整个组以及接受新使用DMARD或TNF-α抑制剂的患者中，疾病活动度和疼痛的改善情况相当（两组分别为71.2%和62.6%）。功能变化方面存在显著差异：平均而言，＜65岁的患者FFbH有中度改善，而老年患者未显示出这种情况（p = 0.04）。仅在年轻患者中显示出RADAI和FFbH的改善之间存在密切相关性。
DMARD或TNF-α抑制剂改善老年RA患者疾病活动度和疼痛的效果不低于年轻患者。然而，与年轻患者相比，老年患者在功能损害方面获益较少。
