Shimizu Masaru, Paudel Misti L, Shadick Nancy, Weinblatt Michael, Solomon Daniel H
Master of Public Health program, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA.
Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
Semin Arthritis Rheum. 2025 Apr;71:152635. doi: 10.1016/j.semarthrit.2025.152635. Epub 2025 Jan 28.
The association between age of rheumatoid arthritis (RA) onset and joint erosions remains unclear. We investigated the effects of age of RA onset on incident joint erosion and the progression of radiographic findings.
Patients diagnosed with RA within 2 years of enrollment in a large single-center RA registry were included. The age of RA onset was categorized into young- (≤44 years of age), middle- (45-65), and late-onset (≥66). Modified total Sharp scores (mTSS) were obtained at baseline, year 2, and year 5, and incident joint erosion was defined as an erosion score >0. Adjusted odds ratio (aOR) of incident joint erosions and adjusted change in mTSS by age category were evaluated over a 5-year follow-up period.
Among 1,581 participants with RA, 284 patients within 2 years of RA diagnosis were identified. The mean mTSS were 0.54 in the young-, 3.12 in the middle-, and 4.77 in the late-onset group. The aOR of incident joint erosion in the middle-, aOR 4.0 (95 % CI 2.2 - 7.5), and the late-onset groups, 8.2 (95 % CI 3.6 - 19.2), were elevated compared with the young-onset group. Compared with the young-onset group, the adjusted changes in mTSS in the middle- group, 2.8 (95 % CI 0.20 - 5.4), and the late-onset groups, 1.9 (95 % CI -0.26 - 4.1), were elevated.
The odds of incident joint erosion and change in the mTSS were increased among patients with later RA onset. Age of RA onset should be considered when determining optimal management strategies.
类风湿关节炎（RA）发病年龄与关节侵蚀之间的关联尚不清楚。我们研究了RA发病年龄对新发关节侵蚀及影像学表现进展的影响。
纳入在一个大型单中心RA登记处登记后2年内被诊断为RA的患者。RA发病年龄分为青年组（≤44岁）、中年组（45 - 65岁）和老年组（≥66岁）。在基线、第2年和第5年获取改良总Sharp评分（mTSS），新发关节侵蚀定义为侵蚀评分>0。在5年随访期内评估各年龄组新发关节侵蚀的调整优势比（aOR）及mTSS的调整变化。
在1581例RA患者中，确定了284例在RA诊断后2年内的患者。青年组的平均mTSS为0.54，中年组为3.12，老年组为4.77。与青年发病组相比，中年组新发关节侵蚀的aOR为4.0（95%CI 2.2 - 7.5），老年组为8.2（95%CI 3.6 - 19.2），均有所升高。与青年发病组相比，中年组mTSS的调整变化为2.8（95%CI 0.20 - 5.4），老年组为1.9（95%CI -0.26 - 4.1），均有所升高。
RA发病较晚的患者发生新发关节侵蚀的几率及mTSS变化增加。在确定最佳管理策略时应考虑RA发病年龄。
