Objective:Rheumatoid arthritis (RA) differs depending on the age of disease onset. The differences between EORA and YORA are important because they have clinical and therapeutic implications.Method:1185 patients were ranked after classification according to age at onset of the disease into YORA I (16–40 years), YORA II (41–60 years) and EORA >60 years. All patients groups were compared, based on disease duration, disease activity, severity parameters and drug history.Results:YORA I included 298 patients, 28.85% were males, with mean age of 29.4 ± 6 years and disease duration 4 ± 3.3 y, YORA II included 539 patients, 33.77% males, age 49.7 ± 6.1 y and disease duration 6.5 ± 5.6 y. EORA included 348 RA patients 40.5% males, age 67.1 ± 6.6 y, disease duration 9.95 ± 7.2 y. Activity was increased in EORA compared to YORA I and YORA II, while severity decreased in EORA. ESR, CRP and degree of anemia were higher in EORA. RF titer was higher in YORA. Small joints of the hands and feet were more involved in YORA, while, large joints in EORA.Rheumatoid nodules were increased in YORA I than EORA P = 0.04. Polymyalgia rheumatica was exclusively present in EORA group 25 patients 7.2%.Methotrexate was used in both YORA and EORA, with a higher mean of dosage in YORA than EORA. Multiple DMARDs in EORA was 57.9%, and biologics in 0.8% was which was significantly lower compared with YORA I, 86.3% and 1.7%, with P = 0.001.Conclusion:EORA has more active and less disabling and affects more males than YORA. The use of biologic therapy and combination DMARD therapy was less in EORA.

The objective of this study was to explain loneliness as experienced by women with rheumatoid arthritis (RA) in a cross-cultural context. We studied 36 Egyptian female RA patients and 140 female Dutch RA patients.. Self-report data were collected about loneliness, physical and psychological health status, social support and social network, needs for help, attitudes and feelings of guilt. Loneliness was significantly higher among Egyptian (44.2 +/- 32.3) than Dutch (12.9 +/- 18.9) female RA patients (F = 54.3, p < 0.001). In Egypt, 36% of the variance of loneliness could be explained by worse affect (anxiety and depression; beta = 0.51), fewer children (beta = 0.31), and higher negative social support for the patients (beta = 0.28) in multiple regression analysis. In the Netherlands, 35% of feeling lonely could be explained by worse affect scores (beta = 0.52), less positive social support for the patients (beta = 0.24), and a higher degree of disability (beta = 0.21). Age of the patients and disease duration only explained 4% and 3% of the loneliness of RA patients in Egypt and the Netherlands, respectively. Female Egyptian RA patients experienced more loneliness than Dutch patients. Affect is the most important and constant variable in explaining loneliness in both countries. The role of the family in perceived loneliness is greater in Egypt than the Netherlands. Low social support received by patients is important in explaining loneliness in the Netherlands but not in Egypt.

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Methods: This was a 24-week, randomized, double-blind, placebocontrolled, Phase III study conducted in Korea that compared adalimumab + MTX vs. placebo + MTX. The primary efficacy endpoint was ACR20 response at Week 24. Secondary endpoints included ACR50/70 and individual components of ACR response criteria. Beginning at Week 18, non-responders [<20% reduction in swollen joint count (SJC) and tender joint count (TJC)] were allowed to switch to openlabel rescue and receive adalimumab 40 mg sc eow. Rescue-treatment patients were considered non-responders at all subsequent visits for ACR response analyses.Results: A total of 128 RA patients enrolled at six Korean sites. Fiftyone of 65 (78.5%) patients randomized to adalimumab + MTX and 40 of 63 (63.5%) patients randomized to placebo + MTX completed the double-blind treatment period. Eight of 65 (12.3%) adalimumab patients and 19 of 63 (30.2%) placebo patients completed the doubleblind period on rescue treatment. Baseline disease characteristics were comparable between groups and representative of moderate-to-severe RA. The ACR response rate at Week 24 was significantly higher in adalimumab patients than in placebo patients: ACR20 (61.5% vs. 36.5%; p < 0.01), ACR50 (43.1% vs. 14.3%; p < 0.001) and ACR70 (21.5% vs. 7.9%; p < 0.05). Significant improvement was also observed in SJC (−9.4 vs. −5.2; p ≤ 0.001), Physician's Global Assessment (−33.9 vs. −21.8; p < 0.05), Disability Index of the KHAQ (−0.6 vs. −0.3; p < 0.05), and CRP concentrations (−1.5 vs. −0.5; p < 0.05). Greater adalimumab patient improvements were seen at Week 24 vs. placebo in all ACR components (last-observation carried forward) (p < 0.05). Adalimumab patients reported a higher rate of no morning stiffness vs. placebo (38.5% vs. 17.5%, p < 0.05). Adalimumab was generally welltolerated, and there were no relevant clinical differences between the two groups in incidences of adverse events (AEs), including severe AEs and related AEs (as judged by the investigator).Conclusions: Adalimumab with concomitant methotrexate showed consistent efficacy in reducing the signs and symptoms of RA in Korean patients vs. placebo + MTX. Adalimumab was generally well-tolerated for up to 24 weeks. Treatment of Korean RA patients with adalimumab has a favorable benefit-risk ratio.