Females with Axial Spondyloarthritis Report Higher Burden of Disease and Worse Patient-reported Outcomes. Results from the International Map of Axial Spondyloarthritis (IMAS)

Victoria Navarro-Compán¹, Marco Garrido-Cumbrera², Denis Poddubnyy³, Christine Bundy⁴, Souzi Makri⁵, Jose Correa Fernandez⁶, Shashank Murlidhar Akerkar⁷, Lillann Wermskog⁸, Elie Karam⁹, Asif Siddiqui¹⁰ and Fernando Sommerfleck¹¹, ¹Department of Rheumatology, La Paz University Hospital, IdiPaz, Madrid, Spain, ²University of Seville, Sevilla, Spain, ³Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité – Universitätsmedizin Berlin, Berlin, Germany, ⁴Cardiff University, Cardiff, United Kingdom, ⁵Cyprus League for People with Rheumatism (CYLPER), Nicosia, Cyprus, ⁶Universidad de Sevilla, Health & Territory Research (HTR), Sevilla, Spain, ⁷Mumbai Arthritis Clinic, Mumbai, India, ⁸Spondyloarthritis Association of Norwary (SPAFO);Axial Spondyloarthritis International Federation (ASIF), Oslo, Norway, ⁹Canadian Spondylitis Association (CSA), Toronto, ON, Canada, ¹⁰Novartis Pharma AG, Basel, Switzerland, ¹¹Sanatorio Julio Mendez, Buenos Aires, Argentina

Meeting: ACR Convergence 2023

Keywords: gender, Patient reported outcomes, spondyloarthritis

Session Information

Date: Tuesday, November 14, 2023

Title: (2195–2226) Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster III: SpA

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: There is increasing evidence of differences between males and females in axial spondyloarthritis (axSpA), but the source is restricted to specific geographic locations or populations. This analysis aims to assess gender differences in a large sample of patients included in the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.

Methods: IMAS is a cross-sectional online survey (2017-2022) of 5,557 unselected axSpA patients from 27 countries. The current analysis looked at the differences in a variety of patient and disease characteristics/assessments between males and females. The factors evaluated were: sociodemographic (age, educational level, marital status, employment status, and patient organization membership), health behaviours (smoking, alcohol consumption, and physical activity), disease characteristics (age at symptom onset, diagnostic delay, HLA-B27, family history of axSpA, uveitis, inflammatory bowel disease), patient-reported outcomes (disease activity [0-10] on the BASDAI scale, spinal stiffness [3-12], functional limitation [0-54], and mental health [0-12] using GHQ-12 scale), mental comorbidities (anxiety, depression, and sleep disorders), and treatments (NSAIDs, csDMARDs and bDMARDs).

Results: Data from 5,555 patients reporting gender were analyzed: 3,492 from Europe, 769 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. Globally, 55.4% were females, with higher proportions in South Africa (82.2%) and lower in Asia (20.8%; Figure 1). Compared to males, females were of a younger age, more frequently university educated, more often divorced, more commonly on permanent sick leave, and less often members of patient organizations. With respect to health behaviours, male participants smoked and drank more than females.Compared to males, diagnostic delay was significantly longer (by 2.4 years) while the rate of HLA-B27 positivity and family history with axSpA were lower in females. With respect to patient-reported outcomes, females presented with higher disease activity, greater functional limitation, and poorer mental health. The use of axSpA drug treatment was more common in females with a higher proportion having ever taken NSAIDs, csDMARDs and bDMARDS (Table 1).

Conclusion: Globally, females with axSpA practiced better health behaviors and reported lower frequency of HLA-B27 positivity but had longer diagnostic delay. Despite more frequently receiving medication, females presented with higher disease activity, greater functional limitation, and worse mental health. Reducing the disease burden and diagnostic delay in females is crucial to improving axSpA care around the world.

Figure 1. Gender proportion by region (N= 5,555)

Table 1. Patient and disease characteristics in males and females with axSpA (N= 5,555)

Disclosures: V. Navarro-Compán: AbbVie, 2, 5, 6, Eli Lilly, 2, 6, Galapagos, 2, Janssen, 6, MoonLake, 2, MSD, 2, 6, Novartis, 2, 5, 6, Pfizer, 2, 6, UCB, 2, 6; M. Garrido-Cumbrera: Novartis, 5; D. Poddubnyy: AbbVie, 2, 5, 6, Biocad, 2, BMS, 6, Eli Lilly, 2, 5, 6, Gilead, 2, GSK, 2, MoonLake, 2, MSD, 2, 5, 6, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, Samsung Bioepis, 2, UCB Pharma, 2, 6; C. Bundy: AbbVie/Abbott, 6, Celgene, 6, Eli Lilly, 6, Janssen, 6, Novartis, 6, Pfizer, 6; S. Makri: GlaxoSmithKlein(GSK), 2, Novartis, 2; J. Correa Fernandez: None; S. Murlidhar Akerkar: Eli Lilly, 6, Janssen, 6, Novartis, 6, Pfizer, 6; L. Wermskog: AbbVie/Abbott, 12, Have not received money, have received money Spondyloarthritis associated of Norway received the support, Eli Lilly, 12, Have not received money, have received money Spondyloarthritis associated of Norway received the support, Novartis, 3, 12, Have not received money, have received money Spondyloarthritis associated of Norway received the support, Pfizer, 12, Have not received money, have received money Spondyloarthritis associated of Norway received the support, UCB, 3, 12, Have not received money, have received money Spondyloarthritis associated of Norway received the support; E. Karam: None; A. Siddiqui: Novartis, 3, 8; F. Sommerfleck: AbbVie/Abbott, 2, 6, Eli Lilly, 6, Janssen, 2, 6, Novartis, 2, 6.

To cite this abstract in AMA style:

Navarro-Compán V, Garrido-Cumbrera M, Poddubnyy D, Bundy C, Makri S, Correa Fernandez J, Murlidhar Akerkar S, Wermskog L, Karam E, Siddiqui A, Sommerfleck F. Females with Axial Spondyloarthritis Report Higher Burden of Disease and Worse Patient-reported Outcomes. Results from the International Map of Axial Spondyloarthritis (IMAS) [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/females-with-axial-spondyloarthritis-report-higher-burden-of-disease-and-worse-patient-reported-outcomes-results-from-the-international-map-of-axial-spondyloarthritis-imas/. Accessed .

« Back to ACR Convergence 2023

ACR Meeting Abstracts - https://acrabstracts.org/abstract/females-with-axial-spondyloarthritis-report-higher-burden-of-disease-and-worse-patient-reported-outcomes-results-from-the-international-map-of-axial-spondyloarthritis-imas/