Eva Salgado1, Montserrat Romera-Baurés2, Emma Beltran-Catalan3, Esperanza Naredo4, Patricia E Carreira5, Mariluz Garcia-Vivar6, Jose V Moreno-Muelas7, Alina Boteanu8, Inma Calvo-Penades9, Agusti Sellas-Fernandez10, Marta Valero11, Juan J Gomez-Reino12. 1. Rheumatology Service, Complejo Hospitalario Universitario, c/ Ramon Puga Noguerol, 54, Ourense 32005 , Spain. Electronic address: eva.salgado.perez@gmail.com. 2. Rheumatology Service, Hospital Universitari Bellvitge, Carrer de la Feixa Llarga, s/n, Barcelona, L'Hospitalet de Llobregat 08907 , Spain. 3. Rheumatology Service, Hospital del Mar, Passeig Marítim de la Barceloneta, 25, 29, Barcelona 08003, Spain. 4. Rheumatology Service, Hospital Universitario Fundación Jiménez Díaz, Av. de los Reyes Católicos 2, Madrid 28040, Spain. 5. Rheumatology Service, Hospital Universitario Doce de Octubre, Av. de Córdoba s/n, Madrid 28041 , Spain. 6. Rheumatology Service, Hospital Universitario Basurto, Montevideo Etorb. 18, Bilbao 48013, Spain. 7. Rheumatology Unit, Hospital Vall d' Hebrón, Passeig de la Vall d'Hebron 119, Barcelona 08035, Spain. 8. Rheumatology Service, Hospital Universitario Ramón y Cajal, M-607 km. 9, 100, Madrid 28034, Spain. 9. Rheumatology Service, Hospital Universitario y Politécnico La Fe, Avinguda de Fernando Abril Martorell, 106, València 46026 , Spain. 10. Rheumatology Service, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, Lleida 25198, Spain. 11. Rheumatology Service, Hospital Universitario Ramón y Cajal, M-607, km. 9, 100, Madrid 28034, Spain. 12. Fundación IDIS, Rheumatology, Complejo Hospitalario Universitario de Santiago, Rúa da Choupana, s/n, Santiago de Compostela 15706 , Spain.
Abstract
BACKGROUND: In immune-mediated inflammatory rheumatic diseases (IMIRD), there are differences between cis-men and cis-women in epidemiology, clinical feature, therapeutic approach, treatment response, and prognosis. In transgender individuals, information concerning IMIRD is not substantial. The assessment of information concerning rheumatic diseases in transgenders is crucial because transgenders may undergo treatments with potential impacts on IMIRD. We aim to collect and discuss current knowledge on IMIRD in transgender individuals, determine the coverage of the literature, identify the knowledge gaps, and highlight opportunities for future research. METHODS: We did a scoping review of publications collected through a systematic search of transgender patients with any IMIRD. Data sources were Medline, Embase, and Web of Knowledge. Synthesis of results and qualitative review of data information was collected in tables. A semi-quantification of the quality of the articles reporting clinical studies was performed. RESULTS: There were 11 transwoman, and 3 transmen cases of systemic lupus erythematosus (5 cases), skin lupus erythematosus (2), systemic sclerosis (4), anti-synthetase syndrome (1), rheumatoid arthritis (1) and ankylosing spondylitis (1). Eleven were de novo cases and three had prior history of IMIRD and developed a comorbidity after starting hormone replacement therapy. The clinical expression of the disease was variable. Two transwomen and one transman developed thrombotic events. The lupus skin lesions in one transman improved following testosterone treatment. No clinical studies were identified. Quality of publications was disparate. CONCLUSION: Although the number of cases is small, most cases of IMIRD occur in transwomen. The absence of solid data warrants caution in establishing recommendations regarding hormone replacement therapy in transgenders with IMIRD. There is an essential need for the consideration of cisgender and transgender particularities in future research on IMIRD.
BACKGROUND: In immune-mediated inflammatory rheumatic diseases (IMIRD), there are differences between cis-men and cis-women in epidemiology, clinical feature, therapeutic approach, treatment response, and prognosis. In transgender individuals, information concerning IMIRD is not substantial. The assessment of information concerning rheumatic diseases in transgenders is crucial because transgenders may undergo treatments with potential impacts on IMIRD. We aim to collect and discuss current knowledge on IMIRD in transgender individuals, determine the coverage of the literature, identify the knowledge gaps, and highlight opportunities for future research. METHODS: We did a scoping review of publications collected through a systematic search of transgender patients with any IMIRD. Data sources were Medline, Embase, and Web of Knowledge. Synthesis of results and qualitative review of data information was collected in tables. A semi-quantification of the quality of the articles reporting clinical studies was performed. RESULTS: There were 11 transwoman, and 3 transmen cases of systemic lupus erythematosus (5 cases), skin lupus erythematosus (2), systemic sclerosis (4), anti-synthetase syndrome (1), rheumatoid arthritis (1) and ankylosing spondylitis (1). Eleven were de novo cases and three had prior history of IMIRD and developed a comorbidity after starting hormone replacement therapy. The clinical expression of the disease was variable. Two transwomen and one transman developed thrombotic events. The lupus skin lesions in one transman improved following testosterone treatment. No clinical studies were identified. Quality of publications was disparate. CONCLUSION: Although the number of cases is small, most cases of IMIRD occur in transwomen. The absence of solid data warrants caution in establishing recommendations regarding hormone replacement therapy in transgenders with IMIRD. There is an essential need for the consideration of cisgender and transgender particularities in future research on IMIRD.
Authors: Nicola Luigi Bragazzi; Charlie Bridgewood; Abdulla Watad; Giovanni Damiani; Dennis McGonagle Journal: Front Immunol Date: 2022-04-22 Impact factor: 8.786