Late-onset rheumatoid arthritis registry study, LORIS study: study protocol and design

Abstract

Background Although drug treatment strategies for rheumatoid arthritis (RA) are relatively well established, there is a paucity of evidence on the treatment in older patients. The purpose of this study is to build a registry for late-onset RA (LORA), which is expected to increase rapidly worldwide. In addition, we aim to propose optimal treatment strategies according to the patient background including frailty, thereby contributing to improving the quality of treatment and daily living in patients with RA. Methods/design The LORIS (Late-onset Rheumatoid Arthritis Registry) Study is a prospective nation-wide multicenter observational study of patients with LORA. The inclusion criteria were patients aged ≥ 65 years at onset, meeting 2010 ACR/EULAR classification criteria for RA, and starting either any disease-modifying antirheumatic drugs (DMARDs) in a DMARD-naïve patient or the first biologic/targeted synthetic DMARDs during the study period. Enrollment was started on 11 January, 2022 and will be closed on 31 December, 2023. Patients will undergo a comprehensive baseline assessment including clinical data, medication, cognitive and physical function, psychosocial factors, and frailty. Data will be collected at baseline, Month 3, 6, 12, 18, 24, 36, and summarized descriptively. The factors associated with adverse events and achieving remission will be determined. Discussion A multi-disciplinary panel including patients, rheumatologists, and geriatric specialists will discuss the results and build a consensus regarding the treatment goals of LORA. We expect to provide a broad range of information for evidence-based shared decision making in the treatment of LORA. Study registration: Registered at the UMIN registry (UMIN000046086) on 1 January 2022.

A preliminary survey of rheumatologists on the management of late-onset rheumatoid arthritis in Japan

“…The survey was performed as part of the study sponsored by The Japan Agency for Medical Research and Development (AMED) project to establish best practice guidelines for patients with LORA (11) based on the ethical spirit of the Declaration of Helsinki and in compliance with relevant laws and regulations in Japan, following the central collective review and approval from the Ethics and Conflict of Interest Committee of the National Center for Geriatrics and Gerontology (approval number 1543).…”

Management of Rheumatoid Arthritis in Elderly Patients

“…There are no guidelines in the literature that provide treatment recommendations for elderly RA patients or guidelines established by relevant associations. However, the LORIS (Late-onset Rheumatoid Arthritis Registry) study is currently carried out by the Japan College of Rheumatology (JCR) and the Japan Rheumatism Friendship Association to provide evidence to update the JCR clinical practice guidelines and is planned to be published in 2024 [31].…”

Unusual presentation of rheumatoid arthritis in a 106‐year‐old woman: A rare case report

“…RA that first appears in people over the age of 60 is commonly referred to as “elderly onset Rheumatoid Arthritis” 3 . Traditional estimates place the peak incidence of RA between the ages of 30 and 50; nevertheless, the number of late‐60s onset cases has been rising in recent years 4 . Elderly‐onset rheumatoid arthritis (EORA) differs from RA that presents before age 60 in a variety of ways, including the prevalence of males, the clinical presentation, the prognosis, the presence of co‐morbid conditions, and the frequency with which an anti‐cyclic citrullinated peptide antibody or rheumatoid factor is positive 5,6 .…”