Effect of age at rheumatoid arthritis onset on clinical, radiographic, and functional outcomes: The ESPOIR cohort

ObjectivesTo investigate whether age at disease onset determines clinical, radiographic or functional outcomes in a cohort of early RA.MethodsThe ESPOIR cohort is a multicenter cohort of patients with early arthritis. We selected patients fulfilling the 2010 ACR/EULAR criteria for RA during the first 3 years of follow-up. Patients were pooled into 3 groups by age at RA onset: < 45 years (young-onset RA [YORA]), 45 to 60 years (intermediate-onset RA [IORA]) and > 60 years (late-onset RA [LORA]). The following outcomes were compared at baseline and during the first 3 years of follow-up: Simple Disease Activity Index (SDAI) remission rate, one additional erosion, Health Assessment Questionnaire Disability Index (HAQ-DI) < 0.5 and first disease-modifying anti-rheumatic drug (DMARD) continuation rate.ResultsWe included 698 patients (median [interquartile range] age 50.3 [39.8–57.2] years), 266 YORA, 314 IORA, and 118 LORA. At 1 year, SDAI remission was greater for YORA than IORA and LORA (P < 0.0001). Having at least one additional erosion was greater for LORA and IORA than YORA after 1 year (P = 0.009) and 3 years (P = 0.017). The proportion of patients with HAQ score < 0.5 was greater for YORA than IORA and LORA at 1 (P = 0.007), 2 and 3 years. First DMARD continuation rate was lower for YORA than other groups during the 3 years (P = 0.005).ConclusionsIn a cohort of early RA, young age at disease onset is associated with high rate of remission at 1 year, no radiographic progression at 3 years and low functional score during 3-year follow-up.