Casper Webers1, Ivette Essers2, Sofia Ramiro3, Carmen Stolwijk2, Robert Landewé4, Désirée van der Heijde3, Filip van den Bosch5, Maxime Dougados6, Astrid van Tubergen7. 1. Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht. 2. Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute, Maastricht University, Maastricht. 3. Department of Rheumatology, Leiden University Medical Center, Leiden. 4. Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, University of Amsterdam, Amsterdam, Department of Rheumatology, Atrium Medical Center, Heerlen, The Netherlands. 5. Department of Rheumatology, Ghent University Hospital and University of Ghent, Ghent, Belgium. 6. Department of Rheumatology, Paris Descartes University, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and INSERM (U1153); Epidemiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France. 7. Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute, Maastricht University, Maastricht, a.van.tubergen@mumc.nl.
Abstract
OBJECTIVES: To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time. METHODS: Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations. RESULTS: A total of 216 patients [154 (72.3%) males, mean age 43.6 years (s.d. 12.7), symptom duration 20.5 years (s.d. 11.8), mean follow-up duration 8.3 years (s.d. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P = 0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P = 0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P = 0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P < 0.01). CONCLUSION: In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time.
OBJECTIVES: To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time. METHODS: Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations. RESULTS: A total of 216 patients [154 (72.3%) males, mean age 43.6 years (s.d. 12.7), symptom duration 20.5 years (s.d. 11.8), mean follow-up duration 8.3 years (s.d. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P = 0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P = 0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P = 0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P < 0.01). CONCLUSION: In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time.
Authors: Sara Khan; Divya Shridharmurthy; Kate L Lapane; Catherine Dube; Jonathan Kay; Esther Yi; Shao-Hsien Liu Journal: Clin Rheumatol Date: 2022-01-06 Impact factor: 2.980
Authors: U Kiltz; J Braun; A Becker; J-F Chenot; M Dreimann; L Hammel; A Heiligenhaus; K-G Hermann; R Klett; D Krause; K-F Kreitner; U Lange; A Lauterbach; W Mau; R Mössner; U Oberschelp; S Philipp; U Pleyer; M Rudwaleit; E Schneider; T L Schulte; J Sieper; A Stallmach; B Swoboda; M Winking Journal: Z Rheumatol Date: 2019-12 Impact factor: 1.372