Evidence map›Paper›PMID 39913010›Full record

ArticleClinical rheumatology2025

International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation.

Nevin Hammam, Tahsin El-Hadidi, Khaled El-Hadidi, Ahmed Elsaman, Samah A El-Bakry, Maha Nassr, Hanan M El-Saadany, Doaa Mosad, Samah I Nasef, Zahraa I Selim and 28 more

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

Nevin HammamRheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Tahsin El-HadidiRheumatology Department, Military Academy, Agouza Rheumatology Center, Giza, Egypt.
Khaled El-HadidiRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed ElsamanRheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.
Samah A El-BakryInternal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt.
Maha NassrRheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Hanan M El-SaadanyRheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt.
Doaa MosadRheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.
Samah I NasefRheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt.
Zahraa I SelimRheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Nermeen SamyInternal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt.
Abdelhfeez MoshrifRheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Hanan TahaInternal Medicine Department, Faculty of Medicine, Rheumatology Unit, Beni-Suef University, Beni-Suef, Egypt.
Rasha M FawzyRheumatology Department, Faculty of Medicine, Benha University, Kalyoubia, Egypt.
Suzan S Al-AdleRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amira M IbrahimRheumatology Department, Faculty of Medicine, Kafr El-Skeikh University, Kafr Al Sheikh, Egypt.
Nora Y ElsaidRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Samar TharwatInternal Medicine Department, Faculty of Medicine, Rheumatology and Immunology Unit, Mansoura University, Dakahlia, Egypt. samartharwat2000@mans.edu.eg.ORCID http://orcid.org/0000-0001-9892-2449
Nada M GamalRheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Maha E IbrahimRheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt.
Soha SenaraRheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Rawhya El ShereefRheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt.
Marwa A AmerRheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Faten IsmailRheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt.
Mervat I Abd ElazeemRheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Nouran M AbazaRheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Eman F MohamedInternal Medicine Department, Faculty of Medicine (Girls), Rheumatology Unit, Al-Azhar University, Cairo, Egypt.
Dina F El-EssawiInternal Medicine Department, Rheumatology Unit (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt.
Saad M ElzokmRheumatology Department, Faculty of Medicine, Al-Azhar University, Damiette, Egypt.
Samar M FawzyRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Nahla N EesaRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Enas A AbdelaleemRheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Ahmed M AbdallaRheumatology and Rehabilitation Department, Faculty of medicine, Damietta University, Damietta, Egypt.
Hanan M FathiRheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Hatem H El-EishiRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Safaa SayedRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Reem Hamdy A MohammedRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Tamer A GheitaRheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElderly-onset rheumatoid arthritis (EORA) may have peculiar findings compared to juvenile-onset RA (JORA). The aim of the work was to present and compare the clinical characteristics of RA patients with JORA and elderly-onset EORA to a group of cases with adult-onset (AORA) and to contrast the findings worldwide.

methodsThe study included 1100 adult RA patients: 209 JORA and 329 EORA, compared with 562 AORA extracted from a big data national study on 10,364 RA patients. Clinical characteristics, laboratory investigations, medications received, and co-morbidities were recorded. The disease activity index (DAS28) and health assessment questionnaire (HAQ) were estimated.

resultsThe JORA cases represented 19% and EORA 29.9% of the included cohort. The mean age at onset for JORA, EORA, and AORA were 15.1 ± 2.1, 64 ± 4.2, and 36.4 ± 10 years (p < 0.0001), and the female-male ratio was 6.2:1, 2.7:1, and 7.3:1 (p < 0.0001), respectively. In EORA, body mass index (28.8 ± 5.8) and frequencies of smokers (11.6%), diabetes (12.2%), hypertension (19.8%), and osteoporosis (5.2%) were significantly higher than in JORA (26.02 ± 5; 5.3%, 2.9%, 3.8%, and 1%) and AORA (27.6 ± 5.6; 3%, 8.4%, 14.9%, and 2.3%, p = 0.016) (p < 0.0001, p = 0.001, p < 0.0001, and p = 0.009, respectively). In JORA, oral ulcers were significantly more frequent (p = 0.04); in EORA, cardiovascular manifestations (p < 0.0001) and hypothyroidism (p = 0.039) were more frequent; and DAS28 (p = 0.01) and HAQ (p = 0.038) were higher. Fibromyalgia and methotrexate administration were significantly more frequent in AORA (p < 0.0001 and p = 0.04, respectively). Rheumatoid factor, anti-cyclic citrullinated peptide, and double seropositivity were significantly more frequent in EORA (p < 0.0001, p = 0.008, and p = 0.002, respectively).

conclusionComorbidities, cardiovascular manifestations, hypothyroidism, higher disease activity, and functional disability are more common in EORA patients. Key Points • Juvenile-onset and elderly-onset RA patients have notable differences compared to the adult-onset cases. • Co-morbidities and certain manifestations, including cardiovascular disease and hypothyroidism, as well as higher disease activity and functional disability, are more common in elderly-onset patients. • Fibromyalgia remains more frequent in adult-onset cases.

Indexed as

Arthritis, JuvenileArthritis, RheumatoidAdultAgedAge of OnsetAntirheumatic AgentsComorbidityFemaleHumansMaleMiddle AgedSeverity of Illness IndexAntirheumatic AgentsAdult-onsetComorbiditiesDAS28Elderly-onsetJuvenile-onsetRheumatoid arthritis

Identifiers

PMID39913010
PMCPMC11865098

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