Influence of sex on disease severity in patients with rheumatoid arthritis.
OBJECTIVE
To determine whether patient's sex influences the severity of rheumatoid arthritis (RA) in terms of clinical severity or need for treatments.


METHODS
This was a retrospective, single-center study. We compared 133 male patients with 133 female patients presenting with RA and matched for disease duration. Data collection included demographic characteristics, pattern of joint involvement, extraarticular manifestations, medical treatment, and joint surgery. Biological measures, HLA genotypes, Larsen radiological scores on radiographs of hands and feet, and Health Assessment Questionnaire (HAQ) results were obtained.


RESULTS
Mean disease duration was 7.4 +/- 6.9 years. Concerning clinical pattern of involvement, sicca syndrome was more frequent in women than in men (p = 0.0003). There were no significant differences concerning absence or presence of at least one disease associated gene (HLA-DRB1*01 or *04) in our patients; however, women more often carried 2 disease associated genes (21% vs 11%). No other difference in clinical, biological, or radiological indicators was noted between the 2 populations. Concerning treatment, there was no difference for large joint arthroplasties; female patients underwent significantly more distal joint arthrodesis, 6.7% vs 1.5% (p = 0.03); they were prescribed slightly more disease modifying drugs, 3.33 vs 2.83 (p = 0.04); and showed a trend toward more large joint arthrodesis, 15% vs 7.5% (p = 0.05), and metacarpophalangeal joint arthroplasties, 5.2% vs 0.7% (p = 0.08).


CONCLUSIONS
When patients are matched for RA duration, sex has little effect on the disease pattern and severity, yet women undergo more distal joint surgery.
Gossec
Laure
L
Department of Rheumatology B, Cochin Hospital, AP-HP, René Descartes University, Paris, France. laure.gossec@cch.aphp.fr
Baro-Riba
Judith
J
Bozonnat
Marie-Cécile
MC
Daurès
Jean-Pierre
JP
Sany
Jacques
J
Eliaou
Jean-François
JF
Combe
Bernard
B
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery; D001178:Arthroplasty / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D012859:Sjogren's Syndrome / Q000453:epidemiology; D011795:Surveys and Questionnaires
D018501:Antirheumatic Agents; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains