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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/15953

Title: The influence of ageing on the development and management of rheumatoid arthritis
Authors: Boots, Annemieke M. H.
Maier, Andrea B.
Masson, Pierre
Lories, Rik J.
De Keyser, Filip
Issue Date: 2013
Citation: NATURE REVIEWS RHEUMATOLOGY, 9 (10), p. 604-613
Abstract: The population of elderly individuals with rheumatoid arthritis (RA) is expanding, due mainly to increasing life expectancy. A variety of theories have been proposed to explain the ageing process, including accumulation of DNA damage and resultant changes in biological processes. Such changes can influence the development and/or course of disease. Furthermore, alterations in biological function determine the biological age-as opposed to chronological age-of an individual, which strongly influences their ability to cope with disease. Moreover, comorbidities are more frequent in elderly individuals. Together, these factors complicate treatment of disease and necessitate careful patient management. Indeed, although evidence from clinical trials suggests that DMARDs and biologic agents have good efficacy and are well tolerated in elderly patients with RA, such individuals are often undertreated and inadequately managed. Unfortunately, insufficient data are available for the development of evidence-based guidelines for this population, as elderly patients are often excluded from clinical trials owing to age restrictions or comorbidities. Thus, additional clinical studies in elderly patients are warranted, with treatment regimens tailored according to vitality or frailty parameters. This Review focuses on the pathophysiological aspects of ageing and their implications for the management of RA in elderly patients.
URI: http://hdl.handle.net/1942/15953
DOI: 10.1038/nrrheum.2013.92
ISI #: 000325145200007
ISSN: 1759-4790
Category: A1
Type: Journal Contribution
Validation: ecoom, 2014
Appears in Collections: Research publications

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