Rheumatoid Arthritis
Conditions
Keywords
Rheumatoid arthritis, Elderly, infections, cardio-vascular disease, osteoporosis, cancer
Brief summary
Rheumatoid arthritis (RA) is associated with a higher prevalence of infections, malignancies, osteoporotic fractures and cardiovascular diseases. Few data are available regarding the prevalence and severity of these comorbidities in elderly RA patients. The purpose of this study is to determine the effect of age on prevalence and severity of comorbidities in RA.
Detailed description
Prevalence of rheumatoid arthritis (RA) in elderly is increasing because of the increasing life expectancy. RA is associated with a higher prevalence of infections, malignancies, osteoporotic fractures and cardiovascular diseases. The purpose of this study is to determine the effect of age on prevalence and severity of comorbidities in RA. This study also aims to determine whether age influences disease progression and efficacy and tolerance of treatments. This study will compare two groups of patients : patients older than 65 years old and patients younger than 50 years old, matched for gender and disease duration. The first part of the study will be cross-sectional and will aim to compare characteristics regarding RA manifestations and comorbidities of the two groups at inclusion. Whereas the second part will be prospective to assess the occurrence of comorbidities and the efficacy and safety of treatments in these two groups. Patients will be assessed every year during 5 years in accordance with usual follow-up of the patients. This study could help to better manage elderly RA patients and to modify clinical practice.
Interventions
None listed
Sponsors
URC-CIC Paris Descartes Necker Cochin
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of Rheumatoid arthritis according to American College of Rheumatology (ACR) /Eular 2010 criteria or American College of Rheumatalogy 1987 criteria * Age \>65 years or patients between 18 and 50 years matched for sex and disease duration with the group of elderly patients (control group)
Exclusion criteria
* Patients who do not understand rules and implications of the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of severe infections | 5 years | Occurrence of severe infection requiring hospitalization or varicella-zoster virus |
| Number of cancers | 5 years | Occurrence of solid cancer or hemopathy |
| Number of cardiovascular diseases | 5 years | Occurrence of myocardial infarction or stroke |
| Number of osteoporotic fractures | 5 years | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of synovitis and/or tenosynovitis at ultrasound of hands | 5 years | to evaluate articular activity of rheumatoid arthritis at ultrasound |
| Health assessment questionnaire (HAQ) score | 5 years | — |
| Need of orthopaedic surgery | 5 years | to evaluate severity of rheumatoid arthritis |
| Disease Activity Score (DAS 28) | 5 years | to evaluate articular activity |
| Number of diabetes, arterial hypertension and dyslipidaemia | 5 years | to evaluate risks factor of cardiovascular disease |
| Number of cataracts | 5 years | — |
| Number of vaccinations | 5 years | Previous influenza vaccination within the previous year and pneumococcal vaccination within the previous 5 years will be searched during medical interview. |
| Number of erosions at X-rays (hands and feet) | 5 years | to evaluate severity of rheumatoid arthritis |
| Simple Disease Activity Index (SDAI) | 5 years | to evaluate clinical articular activity of rheumatoid arthritis |
| Erythrocyte sedimentation rate | 5 years | to evaluate biological articular activity of rheumatoid arthritis |
| Measure of C-reactive protein (CRP) | 5 years | to evaluate biological articular activity of rheumatoid arthritis |
Countries
France
Outcome results
None listed