title: Is long-term radiographic joint damage different between men and women? Prospective longitudinal data analysis of four early RA cohorts with greater than 15 years follow-up.
abstract: OBJECTIVE
  To examine gender-related differences in radiographic joint damage in rheumatoid arthritis (RA) using four prospective early RA cohorts.
  
  
  METHODS
  Radiographs of patients from four early prospective RA cohorts were examined. The extent of joint damage in hands and feet was assessed by three evaluators according to the Larsen score (0-100). Descriptive statistics and two-way bootstrap ANOVA with time as a covariate were employed.
  
  
  RESULTS
  A total of 312 patients were included who had at least 15 years of follow up: 68 from the Rheumatism Foundation Hospital in Heinola in the 1970s (Heinola1970), 117 patients from Lund University Hospital in the 1980s, (Lund1980), and 81 and 46 patients from Jyväskylä Central Hospital in the 1980s (JYV1980) and the 1990s (JYV1990), respectively. Median Larsen scores in seropositive women vs. men were 43 vs. 48 (p=0.57), 37 vs. 34 (p=0.25), 31 vs. 9.5 (p=0.008), and 3.0 vs. 4.0 (p=0.34) in the Heinola1970, Lund1980, JYV1980, and JYV1990 cohorts, respectively. The corresponding figures in seronegative women vs. men were 12 vs. 23 (p=0.59), 2.0 vs. 8.0 (p=0.36), and 1.0 vs. 1.5 (p=0.63), in the Lund1980, JYV1980 and JYV1990 cohorts. All Heinola patients were seropositive.
  
  
  CONCLUSIONS
  After a 15-20 year follow-up period, RA joint damage appears comparable in women and men. The results suggest that management should not differ at least based on gender.
authors.affiliation: Jyväskylä Central Hospital, Jyväskylä, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Asikainen
authors.affiliation: Jyväskylä Central Hospital, Jyväskylä, Finland.
authors.forename: Elena
authors.initials: E
authors.lastname: Nikiphorou
authors.affiliation: University of Tampere, Finland.
authors.forename: Kalevi
authors.initials: K
authors.lastname: Kaarela
authors.affiliation: Lund University, Skane University Hospital, Department of Rheumatology, Lund, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Lindqvist
authors.affiliation: University of Jyväskylä, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
authors.affiliation: Unit of Primary Health Care, Helsinki University Central Hospital, and Department of General Practice, University of Helsinki; and Unit of Primary Health Care, Kuopio University Hospital, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Jyväskylä Central Hospital, Jyväskylä, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Hannonen
authors.affiliation: Jyväskylä Central Hospital, Jyväskylä, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Rannio
authors.affiliation: Jyväskylä Central Hospital; and University of Eastern Finland, Jyväskylä, Finland. tuulikki.sokka-isler@ksshp.fi.
authors.forename: Tuulikki
authors.initials: T
authors.lastname: Sokka
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging* / Q000276:immunology; D001175:Arthrography; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007596:Joints / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D012737:Sex Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D012217:Rheumatoid Factor