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• W2952163071 abstract "Background A population of elderly rheumatoid arthritis (ERA) is increasing, probably due to treatment developed and simply elderly population increase. In aging, functional activity in daily life, immunity, especially T-cell function, and neural response decline and deteriorations become manifested. Treatment must not be same as that of young patient. Objectives To evaluate our treatment method and strategy for ERA. Methods From August 2010 to July 2015, 576 patient who have been treated in the institute continuously for more than 3 years were referred. In these, patients were classified in according with age at baseline (BL); younger than 65 (G-Y), from 65 to 74 (G-O), and no less than 75 (G-OO). Mean 28-joints disease activity score (DAS28), Health Assessment Questionnaire Disability Index (HAQ), Pain Score with visual analog scale (PS-VAS), drug administration history and dosage, were recorded. For ERA, we have adopted a treating strategy called “Touch Down Strategy”, what configures three tactics; 1) From BL, methotrexate (MTX) 6mg/week or tacrolimus (TAC) 1.5mg/day administer. 2) Increase or maintain drug dosage until clinical remission is attained or start bDMARDs when remission is not attained in 3 months, and in case, glucocorticoid (GCS) administered with every other month interval. 3)When clinical remission is attained, GCS tapering started immediately and csDMARDs tapering considered. Tapering of bDMARDs is the last order. ERA patients were treated under these tactics. Monitored DAS28, HAQ score and PS-VAS were calculated for each group and compared with ANOVA with Bonferroni correction. Results HAQ at baseline demonstrated significantly higher in G-OO than the other groups. Prevalence of DAS28 remission were 76.4%, 89.6%, and 87.2%, while mean length from BL to DAS28 remission was 2.9, 2.5 and 4.0 months for G-Y, G-O, and G-OO, respectively. bDMARDs administration ratio was 19.8%, 20.6%, and 18.0%, while mean MTX dosage was 8.6mg, 8.6mg, and 7.4mg/week, for G-Y, G-O, and G-OO respectively. GCS administration ratio and mean dosage until DAS28 remission were 24.2% and 2.96mg, 38.0% and 2.41mg, and 42.6% and 2.71mg/day, while after remission 19.3% and 5.68mg, 21.1% and 4.58mg, and 26.4% and 2.14mg/day, for G-Y, G-O, and G-OO, respectively (Table). Conclusion Our Touch Down Strategy can work effective for ERA, especially for elderly ERA whose age is over 75 years old. Just by doing take care for risk of comorbidities, ERA can be well controlled their disease activity. Disclosure of Interests None declared" @default.
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• W2952163071 date "2019-06-01" @default.
• W2952163071 modified "2023-09-23" @default.
• W2952163071 title "AB0359 TREATING STRATEGY FOR ELDERLY RHEUMATOID ARTHRITIS PATIENT, ESPECIALLY WHOSE AGE IS MORE THAN 75" @default.
• W2952163071 doi "https://doi.org/10.1136/annrheumdis-2019-eular.918" @default.
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