Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease with a higher incidence in older adults. We aimed to analyze the differences in the choice of RA treatment regimens across various age groups. A retrospective cohort study using data from the Ankara Bilkent City Hospital Registry was conducted, involving 3,475 RA patients categorized into three age groups: 18-49, 50-64, and over 65 years. Key variables examined included demographics, comorbidities, and utilization of various treatment modalities, including disease-modifying antirheumatic drugs (DMARDs), tumor necrosis factor-alpha inhibitors (TNFi), targeted synthetic DMARDs (tsDMARDs), and other biological treatments. Statistical analysis was done with Jamovi software. The study found significant differences in drug prescriptions among age groups. Older patients (>65 years) were less likely to be prescribed methotrexate and sulfasalazine but more likely to receive leflunomide and colchicine. A decline in the use of TNFi and tsDMARDs with age was noted, while other biologics were consistently used across all ages. Our findings underscore the impact of age on treatment choices in RA, revealing a tendency towards less aggressive treatment approaches in older patients. We emphasize the importance of re-evaluating current treatment protocols to better accommodate the health needs of the aging RA population and enhance their quality of life.

Key words: Rheumatoid arthritis, tumor necrosis factor-alpha inhibitors, targeted synthetic disease-modifying antirheumatic drugs, biological treatment, age, geriatric