Springer Nature
Clinical Rheumatology
,  volume 44 ,  issue 3 ,  pages 979-988

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

Nevin Hammam 1
, 
Tahsin El-Hadidi 2
, 
Khaled El-Hadidi 3
, 
Ahmed Elsaman 4
, 
Samah A. El-Bakry 5
, 
Maha Nassr 6
, 
Hanan M. El-Saadany 7
, 
Doaa Mosad 8
, 
Samah I. Nasef 9
, 
Zahraa I Selim 1
, 
Nermeen Samy 5
, 
Abdelhfeez Moshrif 10
, 
Hanan Taha 11
, 
Rasha M. Fawzy 12
, 
Suzan S. Al-Adle 3
, 
Amira M. Ibrahim 13
, 
Nora Y Elsaid 3
, 
Samar Tharwat 14
, 
Nada M Gamal 1
, 
Maha E Ibrahim 9
, 
Soha Senara 6
, 
Rawhya El Shereef 15
, 
Marwa A Amer 16
, 
Faten Ismail 15
, 
Mervat I Abd Elazeem 17
, 
Nouran M Abaza 18
, 
Eman F. Mohamed 19
, 
Dina F. El-Essawi 20
, 
Saad M. Elzokm 21
, 
Samar M Fawzy 3
, 
Nahla N. Eesa 3
, 
Enas A Abdelaleem 17
, 
Ahmed M. Abdalla 22
, 
Hanan M. Fathi 6
, 
Hatem H. El-Eishi 3
, 
Safaa Sayed 3
, 
Reem Hamdy A Mohammed 3
, 
Tamer A Gheita 3
1
 
2
 
Rheumatology Department, Military Academy, Agouza Rheumatology Center, Giza, Egypt | 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
11
 
12
 
13
 
Rheumatology Department, Faculty of Medicine, Kafr El-Skeikh University, Kafr Al Sheikh, Egypt | 
14
 
15
 
16
 
17
 
18
 
19
 
20
 
21
 
22
 
Publication type: Journal Article
Publication date: 2025-02-06
Springer Nature
scimago Q2
wos Q2
SJR: 0.855
CiteScore: 5.9
Impact factor: 2.8
ISSN: 07703198, 14349949
Abstract
Background

Elderly-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.

Methods

The 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.

Results

The 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).

Conclusion

Comorbidities, 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.

Found 
Found 

Top-30

Journals

1
Frontiers in Immunology
Frontiers in Immunology, 1, 20%
Frontiers in Immunology
1 publication, 20%
Healthcare
Healthcare, 1, 20%
Healthcare
1 publication, 20%
Reumatologia Clinica
Reumatologia Clinica, 1, 20%
Reumatologia Clinica
1 publication, 20%
Reumatología Clínica (English Edition)
Reumatología Clínica (English Edition), 1, 20%
Reumatología Clínica (English Edition)
1 publication, 20%
Science Bulletin
Science Bulletin, 1, 20%
Science Bulletin
1 publication, 20%
1

Publishers

1
2
3
Elsevier
Elsevier, 3, 60%
Elsevier
3 publications, 60%
Frontiers Media S.A.
Frontiers Media S.A., 1, 20%
Frontiers Media S.A.
1 publication, 20%
MDPI
MDPI, 1, 20%
MDPI
1 publication, 20%
1
2
3
  • We do not take into account publications without a DOI.
  • Statistics recalculated weekly.

Are you a researcher?

Create a profile to get free access to personal recommendations for colleagues and new articles.
Metrics
5
Share
Cite this
GOST |
Cite this
GOST Copy
Hammam N. et al. International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation // Clinical Rheumatology. 2025. Vol. 44. No. 3. pp. 979-988.
GOST all authors (up to 50) Copy
Hammam N. et al. International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation // Clinical Rheumatology. 2025. Vol. 44. No. 3. pp. 979-988.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1007/s10067-025-07356-5
UR - https://link.springer.com/10.1007/s10067-025-07356-5
TI - International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation
T2 - Clinical Rheumatology
AU - Hammam, Nevin
AU - El-Hadidi, Tahsin
AU - El-Hadidi, Khaled
AU - Elsaman, Ahmed
AU - El-Bakry, Samah A.
AU - Nassr, Maha
AU - El-Saadany, Hanan M.
AU - Mosad, Doaa
AU - Nasef, Samah I.
AU - Selim, Zahraa I
AU - Samy, Nermeen
AU - Moshrif, Abdelhfeez
AU - Taha, Hanan
AU - Fawzy, Rasha M.
AU - Al-Adle, Suzan S.
AU - Ibrahim, Amira M.
AU - Elsaid, Nora Y
AU - Tharwat, Samar
AU - Gamal, Nada M
AU - Ibrahim, Maha E
AU - Senara, Soha
AU - Shereef, Rawhya El
AU - Amer, Marwa A
AU - Ismail, Faten
AU - Elazeem, Mervat I Abd
AU - Abaza, Nouran M
AU - Mohamed, Eman F.
AU - El-Essawi, Dina F.
AU - Elzokm, Saad M.
AU - Fawzy, Samar M
AU - Eesa, Nahla N.
AU - Abdelaleem, Enas A
AU - Abdalla, Ahmed M.
AU - Fathi, Hanan M.
AU - El-Eishi, Hatem H.
AU - Sayed, Safaa
AU - Mohammed, Reem Hamdy A
AU - Gheita, Tamer A
PY - 2025
DA - 2025/02/06
PB - Springer Nature
SP - 979-988
IS - 3
VL - 44
SN - 0770-3198
SN - 1434-9949
ER -
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2025_Hammam,
author = {Nevin Hammam and Tahsin El-Hadidi and Khaled El-Hadidi and Ahmed Elsaman and Samah A. El-Bakry and Maha Nassr and Hanan M. El-Saadany and Doaa Mosad and Samah I. Nasef and Zahraa I Selim and Nermeen Samy and Abdelhfeez Moshrif and Hanan Taha and Rasha M. Fawzy and Suzan S. Al-Adle and Amira M. Ibrahim and Nora Y Elsaid and Samar Tharwat and Nada M Gamal and Maha E Ibrahim and Soha Senara and Rawhya El Shereef and Marwa A Amer and Faten Ismail and Mervat I Abd Elazeem and Nouran M Abaza and Eman F. Mohamed and Dina F. El-Essawi and Saad M. Elzokm and Samar M Fawzy and Nahla N. Eesa and Enas A Abdelaleem and Ahmed M. Abdalla and Hanan M. Fathi and Hatem H. El-Eishi and Safaa Sayed and Reem Hamdy A Mohammed and Tamer A Gheita and others},
title = {International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation},
journal = {Clinical Rheumatology},
year = {2025},
volume = {44},
publisher = {Springer Nature},
month = {feb},
url = {https://link.springer.com/10.1007/s10067-025-07356-5},
number = {3},
pages = {979--988},
doi = {10.1007/s10067-025-07356-5}
}
MLA
Cite this
MLA Copy
Hammam, Nevin, et al. “International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical presentation.” Clinical Rheumatology, vol. 44, no. 3, Feb. 2025, pp. 979-988. https://link.springer.com/10.1007/s10067-025-07356-5.