[Diagnosis and treatment of rheumatoid arthritis:toward the best practice. Management of elderly rheumatoid arthritis.]

Elderly rheumatoid arthritis(RA)is classified into 2 clinical subsets, elderly-onset RA(EORA)and younger-onset elderly RA. Anti-CCP antibody positive, high disease activity, presence of bone erosion are associated with progression of joint destruction of EORA, and intensive treatment using a treat-to-target strategy is needed in the patients with the poor prognostic factors. Working ability is one of most important goals for RA and also non-frail status should be goal of elderly RA, since it is associated with health expectancy. Biological DMARDs are slightly less or equally effective in reducing disease activity in elderly patients, and disease duration may have a greater impact on disease outcomes than age. Elderly patients had multi-morbidities and risk factors for serious infections, which make it difficult to establish a treatment strategy for elderly RA. We will discuss the treatment strategy of elderly RA in this review.