Trends in Treatment for Patients with Late-onset Rheumatoid Arthritis in Japan: Data from the NinJa Study

Toshihiro Matsui; Tomoya Yoshida; Takahiro Nishino; Shigeru Yoshizawa; Tetsuji Sawada; Shigeto Tohma

doi:10.1093/mr/roae006

Trends in Treatment for Patients with Late-onset Rheumatoid Arthritis in Japan: Data from the NinJa Study

Mod Rheumatol. 2024 Jan 22:roae006. doi: 10.1093/mr/roae006. Online ahead of print.

Authors

Toshihiro Matsui¹, Tomoya Yoshida¹, Takahiro Nishino¹, Shigeru Yoshizawa², Tetsuji Sawada³, Shigeto Tohma⁴

Affiliations

¹ Department of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
² Department of Rheumatology, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan.
³ Department of Rheumatology, Tokyo Medical University Hospital, Tokyo, Japan.
⁴ Department of Rheumatology, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.

PMID: 38252503
DOI: 10.1093/mr/roae006

Abstract

Objectives: To investigate trends in the treatment of patients with late-onset rheumatoid arthritis (LORA) using data from the National Database of Rheumatic Diseases in Japan (NinJa).

Methods: Patients registered in the NinJa were classified according to disease onset: at <65 years (young-onset rheumatoid arthritis [YORA]); at 65-74 years (early LORA); and at ≥75 years (late LORA). Chronological changes in the treatment and disease activity were compared.

Results: A total of 7,178, 13,171, 15,295, and 15,943 patients were evaluated in 2010, 2013, 2016, and 2019, respectively. In all groups, the use of methotrexate gradually decreased, whereas that of biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) increased; the use of tumor necrosis factor inhibitors (TNFi) decreased, whereas that of non-TNFi increased. LORA was characterized by more single DMARD use, and less methotrexate and biological/targeted synthetic DMARD use. TNFi and interleukin-6 inhibitors were used less frequently, whereas abatacept was utilized more frequently in late versus early LORA. Conventional synthetic DMARD (excluding methotrexate) and glucocorticoid use was higher in late versus early LORA.

Conclusions: This analysis revealed chronological changes in the treatment of LORA in Japan. Differences between early and late LORA suggest that patients are not a homogeneous population.

Keywords: disease-modifying antirheumatic drugs; late-onset rheumatoid arthritis; national data; young-onset rheumatoid arthritis.