GERIATRIC THERAPEUTICS Treatment of Rheumatoid Arthritis in the Elderly

Rheumatoid arthritis is the commonest form of inflammatory arthritis and may have its onset in the elderly or continue into older age with an earlier onset. Patients with elderly-onset rheumatoid arthritis are more likely to have systemic features (weight loss, fever, fatigue) and large joint involvement and these features may result in diagnostic uncertainty. The principles of treatment for rheumatoid arthritis in the elderly or elderly-onset rheumatoid arthritis are to maintain quality of life by eradicating joint inflammation (thus reducing joint damage) while minimising treatment-related adverse effects. Therapies include disease-modifying anti-rheumatic drugs, non-steroidal anti-inflammatory drugs and corticosteroids, and non-pharmacological strategies such as education, diet and exercise. In the elderly, therapy needs to be adjusted to account for the physiology of ageing and the presence of comordidity. J Pharm Pract Res 2005; 35: 151-4