Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy

Maguire, Sinead; Wilson, Fiona; Gallagher, Phil; O’Shea, Finbar

doi:10.1080/03009742.2021.2007609

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…Concerning other sociodemographic and disease characteristics in patients with axSpA, most results are in accordance with the current literature 21. Thus, female with axSpA were older, presented less HLA-B27 positivity, had more peripheral manifestations and more fibromyalgia, which is aligned with previous studies 10 22. On the other hand, while a recent meta-analysis showed that the diagnostic delay in axSpA is longer for females compared with males (8.8 vs 6.5 years),23–25 our analysis only observed a short difference (6.2 vs 5.6 years), which was not statistically significant.…”

Section: Discussionsupporting

confidence: 87%

Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASAS-perSpA study

et al. 2022

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ObjectivesTo investigate the influence of gender on disease outcomes in patients with spondyloarthritis (SpA), including across SpA subtypes.MethodsData from 4185 patients of 23 countries with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or psoriatic arthritis (PsA) from the Assessment of SpondyloArthritis International Society (ASAS)-perSpA study were analysed. Associations between gender and disease activity (Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Score (BASDAI), C-reactive protein (CRP)), function (Bath Ankylosing Spondylitis Functional Index (BASFI)) and overall health (ASAS Health Index (ASAS HI), European Quality of Life Five Dimension (EQ-5D)) outcomes were investigated. Multilevel multivariable linear mixed models adjusted for relevant confounders (and stratified by disease subtype in case of a relevant interaction) were used.ResultsIn total, 65%, 10% and 25% of patients had axSpA, pSpA and PsA, respectively. axSpA was more frequent in males (68%), whereas pSpA and PsA were more frequent in females (53% and 52%, respectively). A significant interaction between gender and disease subtype was found for ASDAS, BASDAI and BASFI. While being female independently contributed to higher BASDAI across the three disease subtypes (with varying magnitude), female gender was only associated with higher ASDAS in pSpA (β (95% CI): 0.36 (0.15 to 0.58)) and PsA (0.25 (0.12 to 0.38)) but not in axSpA (0.016 (−0.07 to 0.11)). No associations were observed between gender and CRP levels. Female gender was associated with higher ASAS HI and EQ-5D, without differences across disease subtype.ConclusionFemale gender is associated with less favourable outcome measures across the SpA spectrum. However, while female gender influences BASDAI across the three subtypes, ASDAS is associated with gender only in pSpA and PsA but not in axSpA. Therefore, ASDAS is an appropriate instrument both for females and males with axSpA.

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Section: Discussionsupporting

confidence: 87%

Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASAS-perSpA study

et al. 2022

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“…In der Groningen-Leuwaarden-Kohorte (GLAS) betrug die Differenz auf Gruppenebene 0,8 BASDAI-Punkte (BASDAI-Werte Männer 3,4 [0,0 bis 9,4] und Frauen 4,2 [0,2 bis 9,6]) [17]. In einer Studie aus Irland wurde untersucht, ob sich die hohen BAS-DAI-Werte bei Frauen durch Unterschiede im Antwortverhalten zu den einzelnen Fragen des BASDAIs erklären lassen [18]. Die Autoren konnten dies ausschließen, fanden aber in allen Fragen ein höheres Scoring der Frauen.…”

Section: Klinische Symptomeunclassified

“…Neben den klinischen Symptomen ist die Lebensqualität bei Patientinnen stärker als bei Patienten eingeschränkt [7, 16,19]. In einer irischen Studie lagen die Werte im AS Quality of Life-Index (ASQoL) bei Frauen signifikant niedriger als bei Männern (7,51 vs. 6,12, p < 0,01) [18]. In der niederländischen OASIS-Kohorte war männliches Geschlecht signifikant mit einer besseren Lebensqualität assoziiert (B = -1,18; 95 % CI: -2,17; -0,20; P = 0,02) [19].…”

Section: Klinische Symptomeunclassified

Geschlechtsspezifische Unterschiede in Diagnostik, Therapie und Versorgung bei Patient*innen mit axialer Spondyloarthritis

Haibel,

Rademacher,

Rodriguez

et al. 2024

Arthritis und Rheuma

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ZUSAMMENFASSUNGBei der axialen Spondyloarthritis gibt es geschlechtsbezogene Unterschiede bei verschiedenen Aspekten der Erkrankung. Patientinnen werden später als Patienten diagnostiziert, müssen mehr Arztbesuche in Kauf nehmen, haben weniger häufig eine röntgenologische Progression hin zur radiografischen axialen Spondyloarthritis, haben mehr und ausgedehntere Schmerzen und leiden häufiger unter peripherer Arthritis und Enthesitis. Sie haben in der Bildgebung mehr Differenzialdiagnosen. In der Therapie sprechen Frauen weniger gut an als Männer und verbleiben auf Therapien weniger lange. Frühere Diagnose, besseres Erkennen der Symptome und eine frühe Einleitung der Therapie könnten die Situation verbessern.

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Impact of sex and gender on axSpA diagnosis and outcomes

Kohn,

Azam,

Hamilton

et al. 2023

Best Practice & Research Clinical Rheumatology

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Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy

Cited by 5 publications

References 43 publications

Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASAS-perSpA study

Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASAS-perSpA study

Geschlechtsspezifische Unterschiede in Diagnostik, Therapie und Versorgung bei Patient*innen mit axialer Spondyloarthritis

Impact of sex and gender on axSpA diagnosis and outcomes

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