Kemal Nas1, Erkan Kiliç2, İbrahim Tekeoğlu1, Yaşar Keskin3, Remzi Çevik4, Betül Sargin5, Sevtap Acer Kasman6, Hakan Alkan7, Nilay Sahin8, Gizem Cengiz9, Nihan Cüzdan10, İlknur Albayrak Gezer11, Dilek Keskin12, Cevriye Mülkoglu13, Hatice Reşorlu14, Şebnem Ataman15, Ajda Bal16, Merve Baykul1, Mehmet Tuncay Duruöz6, Okan Küçükakkaş3, Ozan Volkan Yurdakul3, Meltem Alkan Melikoğlu17, Fikriye Figen Ayhan18, Hatice Bodur19, Mustafa Çaliş20, Erhan Çapkin21, Gül Devrimsel22, Kevser Gök23, Sami Hizmetli24, Ayhan Kamanlı1, Hilal Kocabaş25, Öznur Kutluk26, Nesrin Şen27, Ömer Faruk Şendur5, Murat Toprak28, Sena Tolu29, Tiraje Tuncer26. 1. Division of Rheumatology and Immunology, Department of Physical Medicine and Rehabilitation, School of Medicine, Sakarya University, Sakarya, Turkey. 2. Kanuni Training and Research Hospital, Rheumatology Clinic, Trabzon, Turkey. 3. Department of Physical Medicine and Rehabilitation, Bezmialem Foundation University, Istanbul, Turkey. 4. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Dicle University, School of Medicine, Diyarbakır, Turkey. 5. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Adnan Menderes University, Aydın, Turkey. 6. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Marmara University, İstanbul, Turkey. 7. Department.of Physical Medicine and Rehabilitation, School of Medicine, Pamukkale University, Denizli, Turkey. 8. Department of Physical Medicine and Rehabilitation, School of Medicine, Balıkesir University, Balıkesir, Turkey. 9. Rheumatology Clinic, Van Training and Research Hospital, University of Health Sciences, Van, Turkey. 10. Balıkesir Atatürk City Hospital, Rheumatology Clinic, Balıkesir, Turkey. 11. Department of Physical Medicine and Rehabilitation, School of Medicine, Selcuk University, Konya, Turkey. 12. Department.of Physical Medicine and Rehabilitation, School of Medicine, Kırıkkale University, Kırıkkale, Turkey. 13. Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey. 14. Department of Physical Medicine and Rehabilitation, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey. 15. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey. 16. Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. 17. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Atatürk University School of Medicine, Erzurum, Turkey. 18. Department of Physical Medicine and Rehabilitation, Atilim University Medical School, Ankara, Turkey. 19. Department of Physical Medicine and Rehabilitation, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey. 20. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Erciyes University, Kayseri, Turkey. 21. Department of Physical Medicine and Rehabilitation, School of Medicine, Karadeniz Technical University, Trabzon, Turkey. 22. Department of Physical Medicine and Rehabilitation, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey. 23. Ankara City Hospital, Rheumatology Clinic, Ankara, Turkey. 24. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Cumhuriyet University. Sivas, Turkey. 25. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey. 26. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Akdeniz University, Antalya, Turkey. 27. Department of Rheumatology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey. 28. Department of Physical Medicine and Rehabilitation, School of Medicine, Yuzuncu Yil University, Van, Turkey. 29. Department of Physical Medicine and Rehabilitation, School of Medicine, Medipol University, Istanbul, Turkey.
Abstract
OBJECTIVES: In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. METHODS: Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. RESULTS: A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. CONCLUSION: This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.
OBJECTIVES: In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. METHODS: Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. RESULTS: A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. CONCLUSION: This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.