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The aim of the work was to present and compare the clinical characteristics of RA patients with JORA and elderly-onset EORA to a group of cases with adult-onset (AORA) and to contrast the findings worldwide.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The study included 1100 adult RA patients: 209 JORA and 329 EORA, compared with 562 AORA extracted from a big data national study on 10,364 RA patients. Clinical characteristics, laboratory investigations, medications received, and co-morbidities were recorded. The disease activity index (DAS28) and health assessment questionnaire (HAQ) were estimated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The JORA cases represented 19% and EORA 29.9% of the included cohort. The mean age at onset for JORA, EORA, and AORA were 15.1\u2009\u00b1\u20092.1, 64\u2009\u00b1\u20094.2, and 36.4\u2009\u00b1\u200910\u00a0years (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and the female-male ratio was 6.2:1, 2.7:1, and 7.3:1 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), respectively. In EORA, body mass index (28.8\u2009\u00b1\u20095.8) and frequencies of smokers (11.6%), diabetes (12.2%), hypertension (19.8%), and osteoporosis (5.2%) were significantly higher than in JORA (26.02\u2009\u00b1\u20095; 5.3%, 2.9%, 3.8%, and 1%) and AORA (27.6\u2009\u00b1\u20095.6; 3%, 8.4%, 14.9%, and 2.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.016) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001, <jats:italic>p<\/jats:italic>\u2009=\u20090.001, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001, and <jats:italic>p<\/jats:italic>\u2009=\u20090.009, respectively). In JORA, oral ulcers were significantly more frequent (<jats:italic>p<\/jats:italic>\u2009=\u20090.04); in EORA, cardiovascular manifestations (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and hypothyroidism (<jats:italic>p<\/jats:italic>\u2009=\u20090.039) were more frequent; and DAS28 (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) and HAQ (<jats:italic>p<\/jats:italic>\u2009=\u20090.038) were higher. Fibromyalgia and methotrexate administration were significantly more frequent in AORA (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.04, respectively). Rheumatoid factor, anti-cyclic citrullinated peptide, and double seropositivity were significantly more frequent in EORA (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001, <jats:italic>p<\/jats:italic>\u2009=\u20090.008, and <jats:italic>p<\/jats:italic>\u2009=\u20090.002, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Comorbidities, cardiovascular manifestations, hypothyroidism, higher disease activity, and functional disability are more common in EORA patients.\n<jats:table-wrap>\n                <jats:table>\n                  <jats:tbody>\n                    <jats:tr>\n                      <jats:td align=\"left\" colspan=\"2\">\n                        <jats:bold>Key Points<\/jats:bold>\u2022<jats:italic>\u00a0Juvenile-onset and elderly-onset RA patients have notable differences compared to the adult-onset cases.<\/jats:italic>\u2022<jats:italic>\u00a0Co-morbidities and certain manifestations, including cardiovascular disease and hypothyroidism, as well as higher disease activity and functional disability, are more common in elderly-onset patients.<\/jats:italic>\u2022<jats:italic>\u00a0Fibromyalgia remains more frequent in adult-onset cases.<\/jats:italic>\n                      <\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody>\n                <\/jats:table>\n              <\/jats:table-wrap>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10067-025-07356-5","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T13:58:51Z","timestamp":1738850331000},"page":"979-988","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: The age at disease onset as a fundamental determinant of clinical 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