Background/Purpose:

Rheumatoid arthritis (RA) is suggested to be a more severe disease in women than in men as

disease activity appears higher in women, and men meet remission criteria more often.

Long-term severity of RA can be analyzed from permanent joint damage in radiographs. Our purpose was to study possible differences in the extent of radiographic joint damage between women and men in an early RA cohort at 10 years after diagnosis.

Methods:Our early RA cohort includes 990 patients from a single clinic with a clinical diagnosis of early RA in 1997 – 2004. Radiographs of hands and feet were taken at a 10 year follow-up visit after diagnosis and were analyzed according to the Larsen score (0-100) including MCP I-V, wrists, and MTP II-V.

Results:

Baseline characteristics of 990 patients were: the mean (SD) age 57(16) years, 67% female, 61% seropositive (RF/CCP+ any time over 10 years) and median (IQR) duration of symptoms before diagnosis 6(3, 12) months; 657(66%) patients were available for a 10 year follow up. Reasons for non-attendance among 333 patients included death (52%), high age, multi-comorbidity or institutionalization (10%), moving from the area (12%); 8% declined, 4% were lost to follow-up and 14% miscellaneous reasons. Thus, radiographs were available in 462 women and 195 men with a similar percentage of 66% being seropositive among genders. In seropositive patients, the mean (SD) Larsen score was 7.7(10) in women and 8.1(11) in men, p=0.12. The probability plot was similar for women and men (Figure 1). In seronegative patients, the mean (SD) Larsen score was 1.9(3.8) in women and 2.3(4.5) in men, p=0.29.

Conclusion:

At 10 years after diagnosis, RA joint damage appears similar in both genders. RA severity is comparable between women and men.

Figure. Larsen score in seropositive women and men with early RA at 10 years after diagnosis.