[Rheumatic diseases with initial manifestations in middle age: gout, rheumatoid arthritis and ANCA-associated vasculitides].

Rheumatic diseases are manifested in all ages. First manifestations of gout are frequent between the ages of 40-60 years. Furthermore, the incidence of rheumatoid arthritis increases as well as anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides. Recently new treatment options for gout were established but colchicine, which has been used to treat gout for a long time was also further optimized in its use. Remarkable advantages in the treatment of rheumatoid arthritis towards remission have been made by the introduction of biological agents 10 years ago. In granulomatosis with polyangiitis (formerly Wegener's disease) therapeutic optimization has led to a reduction in toxicity and rituximab has proven to be an effective treatment option.