title: Female patients suffering from inflammatory bowel diseases are treated less frequently with immunosuppressive medication and have a higher disease activity: a subgroup analysis of a large multi-centre, prospective, internet-based study.
abstract: BACKGROUND
  The introduction of immunosuppressants and biologic agents has led to active debate and research about optimal therapeutic strategies considering risk factors and predictors of clinical outcome in inflammatory bowel disease (IBD). Data about gender-specific treatment differences and risk factors is lacking for IBD. The aim of the present study was to evaluate gender-related differences in the treatment of a distinct IBD patient population treated in the Rhein-Main region, Germany.
  
  
  METHODS
  Data about past medical history, disease status and medical treatment of 986 outpatients treated in ten gastroenterological practices and three hospitals were collected from November 1st 2005-July 31st 2007 and analyzed with regard to gender-related differences in therapy and disease management.
  
  
  RESULTS
  With the exception of an extended disease duration in women, no significant gender-related differences in demographic and clinical characteristics were observed. Men showed a significantly higher remission rate than women (p=0.025), while women received significantly less immunosuppressive medication compared to men (p=0.011). In addition, treatment with immunosuppressants was not different in women with child-bearing potential compared to menopausal women.
  
  
  CONCLUSIONS
  Our investigation demonstrates for the first time gender-specific differences in the therapeutic management in a large cohort of IBD patients.
authors.affiliation: First Department of Internal Medicine, Division of Gastroenterology, Goethe-University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Blumenstein
authors.forename: E
authors.initials: E
authors.lastname: Herrmann
authors.forename: N
authors.initials: N
authors.lastname: Filmann
authors.forename: C
authors.initials: C
authors.lastname: Zosel
authors.forename: W
authors.initials: W
authors.lastname: Tacke
authors.forename: H
authors.initials: H
authors.lastname: Bock
authors.forename: A
authors.initials: A
authors.lastname: Dignass
authors.forename: F
authors.initials: F
authors.lastname: Hartmann
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
authors.forename: J
authors.initials: J
authors.lastname: Stein
authors.forename: O
authors.initials: O
authors.lastname: Schröder
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005858:Germany; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D015122:Mercaptopurine / Q000627:therapeutic use; D019804:Mesalamine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012074:Remission Induction; D012720:Severity of Illness Index; D012737:Sex Factors; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D019819:Budesonide; D016572:Cyclosporine; D000069285:Infliximab; D015122:Mercaptopurine; D001379:Azathioprine; D016559:Tacrolimus; D008727:Methotrexate