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2011, Número 1

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Acta Med 2011; 9 (1)


Artritis reumatoide en el paciente mayor

Barragán GJA

Idioma: Español
Referencias bibliográficas: 50
Paginas: 20-25
Archivo PDF: 201.83 Kb.


RESUMEN

La artritis reumatoide (AR) en el paciente mayor es un tema interesante a discutir, ya que existen varios tabúes que hacen más complejo el diagnóstico y el tratamiento. Desde hace algunas décadas el tema sobre el diagnóstico ha generado varias interrogantes tales como: ¿El cuadro clínico es igual que en pacientes con AR de inicio en la juventud? ¿Existen varias formas de inicio de la enfermedad? ¿Se considera una forma más benigna comparada con el inicio más temprano de la enfermedad? ¿Son diferentes los factores pronósticos de este grupo de pacientes? ¿Varía el tratamiento en el paciente mayor? ¿Aumentan los efectos adversos de los medicamentos en estos pacientes? Trataremos de comentar lo que está publicado en la literatura referente a cada pregunta con la finalidad de establecer un panorama más amplio de la enfermedad en el paciente mayor y se pueda establecer el tratamiento más indicado con fundamentos de lo que se conoce hoy en día.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Rasch EK, Hirsch R, Paulose-Ram R et al. Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States. Arthritis Rheum 2003; 48: 917-926.

  2. Laiho K, Tuomilehto J, Tilvis R. Prevalence of rheumatoid arthritis and musculoskeletal diseases in the elderly population. Rheumatol Int 2001; 20: 85-87.

  3. Villa-Blanco JI, Calvo-Alén J. Elderly onset rheumatoid arthritis. Drugs Aging 2009; 26(9): 739-750.

  4. Gonzalez-Gay MA, Hajeer AH, Dababneh A et al. Seronegative rheumatoid arthritis in elderly and polymyalgia rheumatic have similar patterns of HLA association. J Rheumatol 2001; 28: 122-125.

  5. Fries JF, Wolfe F, Apple R et al. HLA–DRB1 genotype associations in 793 white patients from a rheumatoid arthritis inception cohort: frequency, severity, and treatment bias. Arthritis Rheum 2002; 46: 320-2329.

  6. Mattey DL, Hassell AB, Dawes PT et al. Independent association of rheumatoid factor and the HLA–DRB1 shared epitope with radiographic outcome in rheumatoid arthritis. Arthritis Rheum 2001; 44: 1529-1533.

  7. Weyand CM, Hicok KC, Conn DL et al. The influence of HLA–DR B1 genes on disease severity in rheumatoid arthritis. Ann Intern Med 1992; 117: 801-806.

  8. Gregersen PK, Batliwalla F. PTPN22 and rheumatoid arthritis: Gratifying replication. Arthritis Rheum 2005; 52: 1952-1955.

  9. Padyukov L, Silva C, Stolt P et al. A gene-environment interaction between smoking and shared epitope genes in HLA-DR provides a high risk of seropositive rheumatoid arthritis. Arthritis Rheum 2004; 50: 3085-3092.

  10. Liao K, Alfredsson L, Karlson EW. Environmental influences on risk for rheumatoid arthritis. Curr Op Rheum 2009; 21: 279-283.

  11. Tak PP, Bresnihan B. The pathogenesis and prevention of joint damage in rheumatoid arthritis. Arthritis Rheum 2000; 43: 2619-2633.

  12. Ospelt C, Bretano F, Rengel Y et al. Overexpression of tloo-like receptors 3 and 4 in synovial tissue from patients with early rheumatoid arthritis. Arthritis Rheum 2008; 58: 3684-3692.

  13. Feldman M, Brennan FM, Maini RN. Role of cytokines in rheumatoid arthritis. Annu Rev Immunol 1996; 43: 28-38.

  14. Choy E, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 2001; 344: 907-916.

  15. Tutuncu Z, Kavanaugh A. Rheumatic disease in the elderly: Rheumatoid arthritis. Rheum Dis Clin N Am 2007; 33: 57-70.

  16. Deal CL, Meenan RD, Goldenberg DL et al. The clinical features of elderly-onset rheumatoid arthritis. Artritis Rheum 1985; 28: 987-994.

  17. Healey LA. Rheumatoid arthritis in the elderly. Clin Rheum Dis 1986; 12: 173-179.

  18. Bajocchi G, La Corte R, Locaputo A et al. Elderly onset rheumatoid arthritis: clinical aspects. Clin Exp Rheumatol 2000; 18 Suppl. 20: S49-50.

  19. Van der Heijde DMFM, van Reil PLC M, van Leeuwen MA et al. Older versus younger onset rheumatoid arthritis: results at onset and after 2 years of a prospective follow-up study of early rheumatoid arthritis. J Rheumatol 1991; 18: 1285-1289.

  20. Pease CT , Bhakta BB, Devlin J et al. Does the age of onset of rheumatoid arthritis influence phenotype? A prospective study of outcome and prognostic factors. Rheumatology (Oxford) 1999; 38: 228-234.

  21. Naz SM, Farragher TM, Bunn DK et al. The influence of age at symptom onset and length of follow-up on mortality in patients with recent-onset inflammatory polyarthritis. Arthritis Rheum 2008; 58: 985-989.

  22. Villa-Blanco JI, Calvo-Alén J. Elderly onset rheumatoid arthritis. Drug Aging 2009; 26(9): 739-750.

  23. Combe B. Early rheumatoid arthritis: Strategies for prevention and management. Best Pract Res Clin Rheumatol 2007; 21: 27-42.

  24. Smolen JS, van der Heijde DMFM, St Clair W. Predictors of joint damage in patients with early rheumatoid arthritis treated with highdose methotrexate with or without concomitant infliximab: results from the ASPIRE trial. Arthritis Rheum 2006; 54: 702-710.

  25. Aithal GP, Day CP. Nonsteroidal anti-inflammatory drug-induced hepatotoxicity. Clin Liver Dis 2007; 11: 563-575.

  26. Taber SS, Mueller BA. Drug-associated renal dysfunction. Crit Care Clin 2006; 22: 357-374.

  27. Bijlsma JWJ. Analgesia and the patient with osteoarthritis. Am J Ther 2002; 9: 189-197.

  28. Becker JC, Domschke & Thorsten W. Current approaches to prevent NSAID-induced gastropathy – COX selectivity and beyond. Br J Clin Pharmacol 2004; 58: 587-600.

  29. White WB, West ChR, Borer JS et al. Risk of cardiovascular events in patients receiving celecoxib: A meta-analysis of randomized clinical trials. Am J Cardiol 2007; 99: 91-98.

  30. Lockie LM, Gomez E, Smith DM. Low dose adrenocorticosteroids in the management of elderly patients with rheumatoid arthrtitis. Semin Arthritis Rheum 1983; 12: 373-381.

  31. Gorter SL , Bijlsma JW, Cutolo M et al. Current evidence for the management of rheumatoid arthritis with glucocorticoids: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2010; 69: 1010-1014.

  32. Van Schaardenburg D, Valkeme R, Dijkmans BAC et al. Prednisone for elderly-onset rheumatoid arthritis: efficacy and bone mass at one year. Arthritis Rheum 1993; 36: S269.

  33. Kremer JM, Genovese MC, CannonGW et al. Concomitant leflunomide therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate. Ann Intern Med 2002; 137: 726-733.

  34. O ’Dell JR, Haire CE , Erikson N. Treatment of rheumatoid arthritis with methotrexate sulfasalazine and hydroxychloroquine alone, or a combination of all three medications. N Engl J Med 1996; 334: 1287-1291.

  35. Maini R, St Clair EW, Breedweld F et al. Infliximab (chimeric antitumour necrosis factor a monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomized phase II trial. Lancet 1999; 354: 1932-1939.

  36. Moreland LW, Baumgartner SW, Schiff MH et al. Treatment of rheumatoid arthritis with a recombinant human tumour necrosis factor receptor (p75)-Fc fusion protein. N Engl J Med 1997; 337: 141-147.

  37. Fleischman RM, Baumgartner SW, Tindall EA et al. Response to etanercept (enbrel) in elderly patients with rheumatoid arthritis: a retrospective analysis of clinical trials. J Rheumatol 2003; 30(4): 691-696.

  38. Bresnihan B, Alvaro-Garcia JM, Cobby M et al. Treatment of rheumatoid arthritis with recombinant human interleukin-1 receptor antagonist. Arthritis Rheum 1998; 41: 2196-2204.

  39. Kremer JM, Westhovens R, Leon M et al. Treatment of rheumatoid arthritis by selective inhibition of T-cell activation with fusion protein CTLA4Ig. N Engl J Med 2003; 20: 1907-1915.

  40. Edwards JCW, Szczepanski L, Szechinski J et al. Efficacy of B-celltargeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med 2004; 350: 2572-2581.

  41. Emery P, Keystone E, Tony H et al. IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-weeks multicentre randomized placebo-controlled trial. Ann Rheum Dis 2008; 67: 1516-1523.

  42. Maini R, Taylor P, Szechinski J et al. Double-blind randomized controlled clinical trial of the interleukin-6 receptor antagonist, tocilizumab, in European patients with rheumatoid arthritis who had an incomplete response to methotrexate. Arthritis Rheum 2006; 54: 2817-2829.

  43. Tucuntu Z, Reed G, Kremer J et al. Do patients with older-onset rheumatoid arthritis receive less aggressive treatment? Ann Rheum Dis 2006; 65: 1226-1229.

  44. Peyron JG. Epidemiologic and etiologic approach to osteoarthritis. Semin Arthritis Rheum 1979; 8: 288-306.

  45. Banks S. Erosive osteoarthritis: a current review of clinical challenge. Clin Rheumatol 2010; 29: 697-706.

  46. Lawrence RC, Hochberg MD et al. Estimates of the prevalence of selected arthritic and musculoskeletal diseases in the United States. J Reumatol 1989; 16: 427-441.

  47. Cobb KL, Mendez EA, Espinoza LR. Gouty arthritis mimicking rheumatoid arthritis. J Clin Rheumatol 1998; 4: 225.

  48. Michet CJ, Evans JM, Fleming KC et al. Common rheumatologic diseases in elderly patients. Mayo Clin Proc 1995; 70: 1205-1214.

  49. Aletahan D, Funovits J, Breedveld FC et al. Rheumatoid arthritis joint progression in sustained remission is determined by disease activity levels preceding the period of radiographic assessment. Arthritis Rheum 2009; 60: 1242-1249.

  50. Aletaha D, Smolen JS. The definition and measurement of disease modification in inflammatory rheumatic disease. Rheum Dis Clin North Am 2006; 32: 9-44, vii.




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