title: Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.
abstract: The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P < 0.05), although no difference was observed in psoriatic or IBD spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.
authors.affiliation: Rheumatology Section Former Chief of Residents, Rheumatology Section Former Fellow in Rheumatology, Instituto de Rehabilitación Psicofísica Consulting Professor of Rheumatology, University of Buenos Aires School of Medicine Chief, Rheumatology Section Former Fellow in Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Hospital Universitario "José Eleuterio González," Monterrey Hospital General de Mexico, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico DF, Mexico Portuguese Institute of Rheumatology, Lisbon, Portugal Instituto Nacional de Reumatología del Uruguay, Montevideo, Uruguay Department of Clinical Immunology and Rheumatology, Pontificia Universidad Católica de Chile, Santiago, Chile Serviço de Reumatologia e de Doencas Ósseas Metabólicas, Centro Hospitalar Lisboa Norte Facultade de Ciencias Médicas da Universidade Nova de Lisboa and CHLO, Hospital de Egas Moniz, Lisbon, Portugal Chief Rheumatology Unit, Hospital JM Cullen, Sante Fé Centro Médico Privado de Reumatología, Tucumán, Argentina Hospital Luis Vernaza, Guayaquil, Profesora de Inmunología Clínica, Universidad Católica de Guayaquil, Guayaquil, Ecuador Rheumatology Service, Hospital General de Mexico y Facultad de Medicina, UNAM, Mexico DF, Mexico Rheumatology Department, "Reina Sofía" University Hospital / IMIBIC, University of Cordoba, Cordoba, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Landi
authors.forename: Hernán
authors.initials: H
authors.lastname: Maldonado-Ficco
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Perez-Alamino
authors.forename: José A
authors.initials: JA
authors.lastname: Maldonado-Cocco
authors.forename: Gustavo
authors.initials: G
authors.lastname: Citera
authors.forename: Pablo
authors.initials: P
authors.lastname: Arturi
authors.forename: Percival D
authors.initials: PD
authors.lastname: Sampaio-Barros
authors.forename: Diana E
authors.initials: DE
authors.lastname: Flores Alvarado
authors.forename: Rubén
authors.initials: R
authors.lastname: Burgos-Vargas
authors.forename: Elena
authors.initials: E
authors.lastname: Santos
authors.forename: Daniel
authors.initials: D
authors.lastname: Palleiro
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gutiérrez
authors.forename: Elsa
authors.initials: E
authors.lastname: Vieyra-Sousa
authors.forename: Fernando
authors.initials: F
authors.lastname: Pimentel-Santos
authors.forename: Sergio O
authors.initials: SO
authors.lastname: Paira
authors.forename: Alberto
authors.initials: A
authors.lastname: Berman
authors.forename: Claudia Vera
authors.initials: CV
authors.lastname: Barrezueta
authors.forename: Janitzia
authors.initials: J
authors.lastname: Vazquez-Mellado
authors.forename: Eduardo
authors.initials: E
authors.lastname: Collantes-Estevez
mesh_terms: D000328:Adult; D000367:Age Factors; D015535:Arthritis, Psoriatic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000473:pathology*; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012737:Sex Factors; D013166:Spondylitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*