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Late-Onset Disease: Different Age, Different Rules?

Jiha Lee, MD

We’re seeing more patients develop rheumatic diseases for the first time in their 60s, 70s, or beyond. But are these truly the same diseases we see in younger adults, or do they behave differently, shaped by age-related biology, comorbidity, and the biases that influence medical decision-making? Several abstracts presented at EULAR 2025 challenge us to reconsider how we diagnose and treat rheumatic disease in older adults.

Mrinalini Dey Tweet
DrMiniDey
A PT-led vocational intervention for RA/axSpA with reduced work ability was likely cost-effective: ↓€4,324 in societal costs & +0.05 QALYs over 12m vs usual care (95% probability at €20k/QALY). Results suggest cost-effective compared to usual care. @RheumNow #EULAR2025 #OP0007
Jiha Lee Tweet
JihaRheum
#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21). 📉 TNFi, ,RTX also not associated with recurrence @RheumNow #EULAR2025
Mrinalini Dey Tweet
DrMiniDey
In #InflammatoryArthritis, baseline depression was linked to ↑ presenteeism & ↓ QoL at baseline + 3mo, but not absenteeism. Data from 9-country study provide further evidence that mental health is key to supporting work outcomes in RA, PsA & axSpA. @RheumNow #EULAR2025 #OP0028
Jiha Lee Tweet
JihaRheum
Worried about cancer risk with ts/bDMARDs in RA? Real-world data from over 4,600 patients says: don’t be. No increased risk of cancer (incl. NMSC) for JAKi, IL6i, CD20i, or CTLA4-A vs TNFi in long-term registry follow-up. Abstract#OP0065 @RheumNow #EULAR2025
Aurelie Najm Tweet
AurelieRheumo
STAMP RCT early SEC vs. SoC 120pts Retention 58% vs 30% ACR 20, 50, 70 and MDA: better outcome at Month 3 but no difference at Month 6 Dactylitis no difference Of note here SoC was a tight T2T strategy! @RheumNow #OP0092 #EULAR2025 https://t.co/8zHs5CRFV5
Janet Pope Tweet
Janetbirdope
What happens in pre-RA when you stop #abatacept after 1 yr Rx At 6 yrs approx 60% on #Placebo V 50% who initially got #ABA Prolonged damped effect of development of #RA NNT for 1 yr is ~10 with a range as low as 6 #EULAR2025 @RheumNow @eular_org Abst#OP0004 https://t.co/1VOEaZ00Ia
Dr. John Cush Tweet
RheumNow
UK Natl Early Inflammatory Arthritis Audit (5/18-11/19) compared 2120 PsA & RA (1:1). PsA had longer Sx to referral wait (112 v 89 days; HR 0.87), longer delay in Dx (HR 0.8), PsA less DMARD use at baseline (54% v 69%) & higher DAS28 results at 3 mos (+0.27) https://t.co/zyubhGxw47
Dr. John Cush Tweet
RheumNow
POSTER HALL PRESENTATION: Sponsored by AbbVie Medical Affairs + Health Impact. 🔍Real-world outcomes in patients with RA remaining on first-line TNFi 📽️See Dr. Charles-Schoeman discuss subsequent outcomes in patients who did or did not achieve response at 3 or 6 months https://t.co/8RmcigG7SF
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