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Rheumatology (Oxford). 2016 Mar;55(3):419-28. doi: 10.1093/rheumatology/kev340. Epub 2015 Sep 18.

Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study.

Author information

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.

KEYWORDS:

ankylosing spondylitis; epidemiology; gender; longitudinal studies; sex

PMID:
26385369
DOI:
10.1093/rheumatology/kev340
[Indexed for MEDLINE]

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