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Adult-onset Still’s disease with elderly onset: results from a multicentre study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

 

  1. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
  2. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
  3. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
  4. Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  5. Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  6. Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  7. Rheumatology Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
  8. Rheumatology Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
  9. Research Centre of Systemic Auto-Inflammatory Diseases, Behçet’s Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Rheumatology Unit, Policlinico Le Scotte, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  10. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
  11. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
  12. Rheumatic and Systemic Autoimmune Diseases Unit, Department of Interdisciplinary Medicine (DIM), University of Bari Medical School, Bari, Italy.
  13. Rheumatology and Immunology Unit, Department of Medicine, University of Rome Campus Biomedico, Rome, Italy.
  14. Academic Rheumatology Centre, Ospedale Mauriziano, Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Italy.
  15. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Italy.
  16. Rheumatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital P. Giaccone, Palermo, Italy.
  17. Rheumatic and Systemic Autoimmune Diseases Unit, Department of Interdisciplinary Medicine (DIM), University of Bari Medical School, Bari, Italy.
  18. Research Centre of Systemic Auto-Inflammatory Diseases, Behçet’s Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Rheumatology Unit, Policlinico Le Scotte, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  19. Research Centre of Systemic Auto-Inflammatory Diseases, Behçet’s Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Rheumatology Unit, Policlinico Le Scotte, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  20. Rheumatology Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
  21. Rheumatology Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
  22. Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  23. Rheumatology and Immunology Unit, Department of Medicine, University of Rome Campus Biomedico, Rome, Italy.
  24. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
  25. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy. piero.ruscitti@univaq.it

CER15433
2022 Vol.40, N°8
PI 1517, PF 1525
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PMID: 35579097 [PubMed]

Received: 21/12/2021
Accepted : 14/03/2022
In Press: 04/05/2022
Published: 14/09/2022

Abstract

OBJECTIVES:
In this study, we aimed at describing the clinical characteristics, life-threatening complications occurrence, and mortality of adult-onset Still’s disease (AOSD) patients with elderly onset.
METHODS:
A multicentre retrospective study of prospectively followed-up AOSD patients included in Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort was performed.
RESULTS:
Out of 221 assessed patients, 37 (16.7%) had an onset of the disease aged over 60 years. When compared with younger patients, these were characterised by a higher prevalence of pericarditis (p=0.008), comorbidities (p<0.0001), and mortality (p=0.023). Age predicted the presence of serositis in both univariate (HR: 1.02, 95%CI: 1.01-1.03, p=0.007) and multivariate analyses (HR: 1.02, 95%CI: 1.01-1.04, p=0.007). Age was also a significant predictor of parenchymal lung disease in both univariate (HR: 1.03, 95%CI: 1.01-1.05, p=0.017) and multivariate analyses (HR: 1.03, 95%CI: 1.00-1.05, p=0.048). Furthermore, age resulted to be a negative predictor of polycyclic pattern only in univariate analysis (HR: 0.99, 95%CI: 0.97-1.00, p=0.048). Finally, age significantly predicted the mortality in both univariate (HR: 1.03, 95%CI: 1.00-1.06, p=0.034) and multivariate analyses (HR: 1.05, 95%CI: 1.01-1.08, p=0.012).
CONCLUSIONS:
Clinical features of AOSD patients in the elderly were described in our cohort. Although the main clinical characteristics were similar comparing older and younger patients, patients aged over 60 years at disease onset were characterised by an increased prevalence of serositis, comorbidities, mostly cardiometabolic, and a higher mortality rate. Age predicted the presence of parenchymal lung disease and mortality, and it could be considered a negative prognostic factor in AOSD.

DOI: https://doi.org/10.55563/clinexprheumatol/0215kv

Rheumatology Article