Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: In patients with spondyloarthritis, published data indicate different manifestations and outcomes between genders. The evidence in this regard in patients with early and peripheral disease is lacking. The aim of this study is to describe if there are differences in the presentation between genders in patients with early axial and peripheral spondylarthritis (axSpA, pSpA).
Methods: This study was carried out within the framework of the ESPeranza program, which was a national multicenter initiative aiming to facilitate early diagnosis and follow-up of patients with spondylarthritis in Spain between 2008-2011. Out of 775 patients referred, 377 patients fulfilled the ASAS classification criteria for SpA: 291 (77%) axSpA and 86 (23%) pSpA. Demographic and disease characteristics were compared between genders using a descriptive analysis through Student t test (for continuous variables) and Chi-square test (for categorical variables).
Results: In total, 241 (64%) patients were males (191 axSpA and 50 pSpA). In axSpA, males had significantly more frequently radiographic sacroiliac damage, elevated CRP, HLA-B27+ and morning stiffness, while females had higher values of ESR and more frequency of peripheral arthritis (Table1-2). In pSpA, male gender was significantly associated with diagnostic delay, psoriasis and elevated CRP while women had higher rates of functional limitation.
Conclusion: There are differences in the manifestations between genders already from the onset of the disease. In patients with axSpA, males have worst prognostic factors compared with females. However, in pSpA, females report poorer functionality despite being diagnosed earlier than male patients. This difference in phenotypes may influence on therapeutic decision-making.
Table 1.
|
Characteristic n: 377 |
Axial Spondylarthritis n: 291 |
|
|
|
Males 191 |
Females 100 |
P value |
|
|
Age (years) |
31.6 ± 7.1 |
32.8 ± 6.8 |
0.2 |
|
Family history |
67 (35.1) |
34 (34.0) |
0.9 |
|
Symptoms duration (months) |
13.1 ± 6.9 |
12.7 ± 6.4 |
0.6 |
|
Morning stiffness |
138 (72.3) |
60 (60.0) |
0.03 |
|
IBP (ASAS criteria) |
74 (38.7) |
38 (38.0) |
0.9 |
|
Arthritis |
42 (22.0) |
11 (11.0) |
0.02 |
|
Enthesitis |
38 (19.9) |
19 (19.0) |
0.9 |
|
Dactylitis |
13 (6.8) |
3 (3.0) |
0.2 |
|
Psoriasis |
23 (12.0) |
10 (10.0) |
0.6 |
|
IBD |
8 (4.2) |
1 (1.0) |
0.1 |
|
Uveitis |
11 (5.8) |
12 (12.0) |
0.06 |
|
Diarrhea, cervicitis, urethritis |
5 (2.6) |
6 (6.0) |
0.2 |
|
HLA-B27 |
151 (79.1) |
68 (68.0) |
0.03 |
|
CRP (mg/L) |
12.4 ± 16.6 |
7.8 ± 11.7 |
0.01 |
|
ESR (mmHg) |
12.3 ± 13.9 |
16.0 ± 12.5 |
0.04 |
|
SJC (0-68) |
0.3 ± 1.6 |
0.2 ± 0.6 |
0.2 |
|
VAS (0-100) physician |
30 ± 22 |
28 ± 22 |
0.5 |
|
VAS (0-100) patient |
40 ± 26 |
45 ± 29 |
0.2 |
|
BASDAI (0-10) |
3.7 ± 2.2 |
4.0 ± 2.3 |
0.3 |
|
BASFI (0-10) |
2.2 ±2.3 |
2.6 ±2.4 |
0.2 |
|
BASMI (0-10) |
1.4 ± 1.3 |
1.5 ± 1.1 |
0.4 |
|
MASES (0-13) |
0.5 ± 1.2 |
0.5 ± 1.5 |
0.9 |
|
Sacroiliitis on x Ray (m NY criteria) |
81 (42.4) |
28 (28.0) |
0.02 |
|
Sacroiliitis on MRI (ASAS criteria) |
72 (37.7) |
53 (53.0) |
0.3 |
|
Disability to work (%) |
24 (12.5) |
7 (7.0) |
0.2 |
|
ASQoL (0-18) |
5.5 ± 4.9 |
6.6 ± 4.5 |
0.08 |
Table 2.
|
Characteristic n: 377 |
Periferical Spondylarthritis n:86 |
||
|
Males 50 |
Females 36 |
P value |
|
|
Age (years) |
33.1 ± 8.4 |
32.4 ± 6.9 |
0.7 |
|
Family history |
15 (30.0) |
16 (44.4) |
0.2 |
|
Symptoms duration (months) |
10.4 ± 6.4 |
7.7 ± 5.5 |
0.04 |
|
Morning stiffness |
3 (6.0) |
3 (8.3) |
0.7 |
|
IBP (ASAS criteria) |
|||
|
Arthritis |
48 (96.0) |
35 (97.2) |
0.8 |
|
Enthesitis |
28 (56.0) |
15 (41.7) |
0.2 |
|
Dactylitis |
17 (34.0) |
11 (30.6) |
0.7 |
|
Psoriasis |
21 (42.0) |
7 (19.4) |
0.03 |
|
IBD |
6 (12.0) |
4 (11.1) |
0.9 |
|
Uveitis |
1 (2.0) |
0 (0) |
0.4 |
|
Diarrhea, cervicitis, urethritis |
4 (8.0) |
1 (2.8) |
0.3 |
|
HLA-B27 |
16 (32.0) |
12 (33.3) |
1.0 |
|
CRP (mg/L) |
17.4 ± 39.5 |
8.6 ± 11.5 |
0.1 |
|
ESR (mmHg) |
11.9 ± 14.1 |
17.4 ± 11.6 |
0.09 |
|
SJC (0-68) |
1.4 ± 2.4 |
1.3 ± 2.3 |
0.8 |
|
VAS (0-100) physician |
22 ± 19 |
27 ± 25 |
0.4 |
|
VAS (0-100) patient |
29 ± 22 |
35 ± 29 |
0.4 |
|
BASDAI (0-10) |
3.2 ± 2.1 |
3.8 ± 2.4 |
0.2 |
|
BASFI (0-10) |
1.3 ± 1.4 |
2.3 ± 2.3 |
0.04 |
|
BASMI (0-10) |
1.2 ± 1.1 |
1.4 ± 1.0 |
0.5 |
|
MASES (0-13) |
0.2 ± 0.6 |
0.2 ± 0.4 |
0.6 |
|
Sacroiliitis on x Ray (m NY criteria) |
|||
|
Sacroiliitis on MRI (ASAS criteria) |
|||
|
Disability to work (%) |
13 (26.0) |
6 (16.7) |
0.5 |
|
ASQoL (0-18) |
4.1 ± 4.7 |
4.9 ± 5.3 |
0.5 |
To cite this abstract in AMA style:
Urrego C, Navarro-Compán V, De Miguel E, Mulero Mendoza J, Ruiz Jimeno T, Campos Fernandez C, Zurita Prada P. Gender Differences in Axial and Peripheral Spondyloarthritis: Results from the Esperanza Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/gender-differences-in-axial-and-peripheral-spondyloarthritis-results-from-the-esperanza-cohort/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/gender-differences-in-axial-and-peripheral-spondyloarthritis-results-from-the-esperanza-cohort/