Background/Purpose:

Systemic sclerosis (SSc) has a female predominance with a female-to-male ratio of 3:1. Sex differences have been seen in many autoimmune diseases; however, little is understood about the effect of sex on SSc disease manifestations and survival. The objectives of this study were to evaluate differences in survival and disease manifestatons between males and females with SSc.

Methods:

We conducted a retrospective cohort study of patients from the Toronto Scleroderma Program who fulfilled the American College of Rheumatology (ACR) classification criteria for SSc and were >16 years of age. We evaluated differences in age of onset, disease manifestations, serology, and survival between males and females.

Results:

907 patients (745 females, 162 males) were included. Males more frequently had diffuse SSc than women (45% versus 31%, p = 0.007). Men were more likely to have renal crisis (10% versus 7%), abnormal nail fold capillaries (30% versus 25%), digital ulcers (35% versus 32%), esophageal dysmotility (89% versus 85%), telangiectasia (81% versus 77%), and interstitial lung disease (42% versus 32%). Females more frequently had anticentromere antibodies (19% versus 9%), pulmonary arterial hypertension (38% versus 33%), and Raynaud’s phenomenon (96% versus 94%). There were 186 deaths (37 males, 149 females). Males had increased mortality compared to females (Hazard Ratio (HR) 1.56, p=0.02). The median survival time was 17.3 years for males and 24.7 years for females. After adjusting for differences in SSc subtype, serology and presence of interstitial lung disease, men still had increased mortality compared to females (HR 1.64, p = 0.009).

Conclusion:

Males with SSc have an increased burden of disease and decreased survival compared to females with SSc.

---

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-male-sex-on-survival-in-systemic-sclerosis/