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Although female patients with ankylosing spondylitis score worse on disease activity than male patients and improvement in disease activity is comparable, male patients show more radiographic progression during treatment with TNF-alpha inhibitors

van der Slik, B., Spoorenberg, A., Wink, F., Bos, R., Bootsma, H., Maas, F. & Arends, S., Apr-2019, In : SEMINARS IN ARTHRITIS AND RHEUMATISM. 48, 5, p. 828-833 6 p.

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  • Although female patients with ankylosing spondylitis score worse on disease activity than male patients and improvement in disease activity is comparable, male patients show more radiographic progression during treatment with TNF-α inhibitors

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DOI

Background: The clinical presentation of ankylosing spondylitis (AS) differs between genders. Our aim was to investigate differences in disease activity, disease outcome and treatment response between male and female AS patients before and after starting tumor necrosis factor (TNF)-alpha inhibitors in daily clinical practice.

Methods: Patients from the Groningen Leeuwarden AS (GLAS) cohort who started TNF-alpha inhibitors and who had visits at baseline and after 3 months and/or 2 years of follow-up were included.

Results: Of 254 included AS patients, 69% were male. At baseline, female patients scored significantly higher on BASDAI, ASDAS, and tender entheses than male patients. In contrast, CRP, swollen joints, and history of extra-articular manifestations were comparable between genders. Women experienced significantly worse physical function and QoL, whereas men showed significantly more kyphosis and spinal radiographic damage. After 3 months and 2 years of follow-up, all clinical assessments improved significantly, with comparable mean change scores for female and male patients; mean 2-year change in BASDAI -2.7 vs. -2.7, ASDAS -1.50 vs. -1.68, tender entheses -2.4 vs. -1.4, CRP -8 vs. -8, BASFI -2.2 vs. -2.1 and ASQoL -5 vs. -4, respectively. Radiographic progression was significantly higher in male patients. Female patients switched more frequently to another TNF-alpha inhibitor during 2 years of follow-up (32% vs. 14%).

Conclusion: Although female patients experienced higher disease activity, worse physical function and quality of life, and switched TNF-alpha inhibitors more often, clinical improvement during treatment with TNF-alpha inhibitors was comparable between genders. However, male patients showed more radiographic spinal damage after 2 years. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)828-833
Number of pages6
JournalSEMINARS IN ARTHRITIS AND RHEUMATISM
Volume48
Issue number5
Publication statusPublished - Apr-2019

    Keywords

  • Ankylosing spondylitis, Gender differences, Disease activity, Quality of life, Anti-TNF treatment, TNF-alpha inhibitors, QUALITY-OF-LIFE, SEX-DIFFERENCES, PAIN, GENDER, HEALTH, CONTINUATION, PREDICTORS, ARTHRITIS, THERAPY, UPDATE

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