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Elderly-onset rheumatoid arthritis is a unique disease subset associated with poor overall outcomes: response to the letter by Haroon and Ayamer

dc.contributor.authorRomão, Vasco C.
dc.contributor.authorFonseca, João Eurico
dc.contributor.authorPitzalis, Costantino
dc.date.accessioned2023-06-14T13:37:41Z
dc.date.available2023-06-14T13:37:41Z
dc.date.issued2021
dc.description© 2020 Elsevier Inc. All rights reserved.pt_PT
dc.description.abstractWe thank Haroon and Ayamer for their interest in our study, and for reporting their data on the outcomes of elderly-onset rheumatoid arthritis (EORA). Their findings mostly overlap ours, in describing a population with greater male gender representation, similar frequency of seropositivity, and severe, rapidly-deforming disease, requiring more intensive disease-modifying anti-rheumatoid (DMARD) therapy, in comparison to its younger-onset RA (YORA) counterpart. Of note, long-term low dose glucocorticoid therapy was often needed in this subgroup of patients, with frequent flares observed following tapering. In line with this, a recent study also showed that patients with EORA, but not YORA, had a lower risk of biologic DMARD discontinuation if concurrently treated with glucocorticoids. Overall, these findings are in accordance with the concept that EORA is a unique subset characterized by poor prognosis at multiple levels. This contradicts a previously held view of EORA as a benign form of disease. In fact, recent studies — including our own in a cohort of untreated patients with early arthritis — have shown that EORA is associated with worse clinical and imaging outcomes. Moreover, we could demonstrate that the poor features of EORA were also mirrored at the synovial tissue level, with pathologically-resistant disease that was less responsive to promptly started immunosuppressive treatment.pt_PT
dc.description.sponsorshipThis work was supported by the Medical Research Council (grant number 36661, to PEAC); Arthritis Research UK (now Versus Arthritis; Experimental Arthritis Treatment Centre Grant, number 20022, to Centre for Experimental Medicine and Rheumatology); Fundação para a Ciência e Tecnologia (Interno Doutorando Bursary reference SFRH/SINTD/95030/2013, to VCR); European League Against Rheumatism (EULAR Scientific Training Bursary 2014, to VCR); and Sociedade Portuguesa de Reumatologia (Fundo de Apoio à Investigação da SPR 2015, to VCR).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSemin Arthritis Rheum. 2021 Oct;51(5):e11-e12pt_PT
dc.identifier.doi10.1016/j.semarthrit.2020.09.015pt_PT
dc.identifier.issn0049-0172
dc.identifier.urihttp://hdl.handle.net/10451/58204
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationSYNOVIAL PATHOBIOLOGY AND PATIENT STRATIFICATION IN RHEUMATOID ARTHRITIS
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/seminars-in-arthritis-and-rheumatismpt_PT
dc.titleElderly-onset rheumatoid arthritis is a unique disease subset associated with poor overall outcomes: response to the letter by Haroon and Ayamerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleSYNOVIAL PATHOBIOLOGY AND PATIENT STRATIFICATION IN RHEUMATOID ARTHRITIS
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FSINTD%2F95030%2F2013/PT
oaire.citation.endPagee12pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPagee11pt_PT
oaire.citation.titleSeminars in Arthritis and Rheumatismpt_PT
oaire.citation.volume51pt_PT
person.familyNameC Romão
person.familyNameFonseca
person.givenNameVasco
person.givenNameJoão
person.identifier490119
person.identifier.ciencia-id771D-0A5C-626B
person.identifier.ciencia-idF310-B85D-57C7
person.identifier.orcid0000-0002-5603-9436
person.identifier.orcid0000-0003-1432-3671
person.identifier.ridO-8224-2014
person.identifier.scopus-author-id55989452300
person.identifier.scopus-author-id7101983519
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione7e94139-add7-4a3b-b138-fb1d1a656b0e
relation.isAuthorOfPublication1772dc12-7c55-4c76-ae2d-c23270172480
relation.isAuthorOfPublication.latestForDiscoverye7e94139-add7-4a3b-b138-fb1d1a656b0e
relation.isProjectOfPublication19261111-c899-4b70-b891-50aab0ec00c4
relation.isProjectOfPublication.latestForDiscovery19261111-c899-4b70-b891-50aab0ec00c4

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