Gender Differences in Axial and Peripheral Spondyloarthritis

This article is part of Rheumatology Advisor’s 2017 in-depth coverage of ACR, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for spondyloarthritis. Click here to read more of Rheumatology Advisor‘s conference coverage.

SAN DIEGO — Men with axial spondylarthritis (axSpA) have been found to have a worse prognosis compared with affected women, whereas peripheral spondylarthritis (pSpA) decreases functionality to a greater degree in women vs men, according to a study presented at the ACR/ARHP 2017 Annual Meeting, held November 3-8 in San Diego, California.

Using the framework from the ESPeranza program, researchers examined follow-up outcomes in patients with early axSpA (n=291) and pSpA (n=86). Approximately 64% of the study’s cohort were men (n=241).

Men vs women with axSpA were found to have more frequent rates of sacroilitis (28.0% vs 42.4%; P =.02), more reports of morning stiffness (60.0% vs 72.3%; P =.03), and higher levels of C-reactive protein (7.8±11.7 mg/L vs 12.4±16.6 mg/L; P =.01). Conversely, women vs men with axSpA were found to have higher ESR values (16.0 ± 12.5 mm/hr vs 12.3±13.9 mm/hr; P =.04) and a trend toward an increase in incidence of uveitis (12.0% vs 5.8%; P =.06). 

In patients with pSpA, men had significantly greater rates of psoriasis (42.0% vs 19.4%; P =.03), numerically higher levels of C-reactive protein (17.4±39.5 mg/L vs 8.6±11.5 mg/L; P =.10), and longer diagnostic delays than women. Overall, women tended to have greater functional limitations than men.

The investigators believe the gender differences highlighted in this study may ultimately “influence therapeutic decision-making” in axSpA and pSpA.

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Reference

Urrego C, Navarro-Compán V, Miguel ED, et al. Gender differences in axial and peripheral spondyloarthritis: results from the Esperanza Cohort. Presented at: ACR/ARHP 2017 Annual Meeting, November 3-8, 2017, San Diego, California. Abstract 2499.