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Management of common types of arthritis in older adults 

Management of common types of arthritis in older adults
Chapter:
Management of common types of arthritis in older adults
Source:
Oxford Textbook of Geriatric Medicine (3 edn)
Author(s):

James B. Galloway

and David L. Scott

DOI:
10.1093/med/9780198701590.003.0075

The main forms of inflammatory arthritis are rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. They are long-term disorders and consequently their prevalence increases with age; the lifetime risk of developing rheumatoid arthritis is over 3% in women. Their characteristic features comprise joint pain, swelling, and tenderness, morning stiffness, and general symptoms such as malaise. Polyarthritis is commoner in rheumatoid arthritis. The ESR and C-reactive protein levels are high in active arthritis. The main radiological finding is erosive disease. Symptomatic treatment includes analgesics and non-steroidal anti-inflammatory drugs. Disease-modifying drugs (DMARDs) change the course of these diseases; their main use is in rheumatoid arthritis. Biologic drugs help when other treatments are insufficient; they include tumour necrosis factor inhibitors which benefit all types of inflammatory arthritis, and other biologics targeting B- and T-cells are mainly used in rheumatoid arthritis. The risks of adverse events and drug toxicity are higher in elderly patients.

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