HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) All Versions of this Article: ard.2006.060293v1 66/5/633    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lee, W. Articles by Weisman, M. H Search for Related Content PubMed PubMed Citation Articles by Lee, W. Articles by Weisman, M. H

Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort

¹ Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
² Division of Rheumatology and Clinical Immunogenetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
³ Division of Rheumatology, University of California, San Francisco, California, USA
⁴ Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
⁵ National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to:
Correspondence to:
Professor M H Weisman
Cedars-Sinai Medical Center, Division of Rheumatology, 8700 Beverly Boulevard, B-131 Los Angeles, CA 90048, USA; weisman{at}cshs.org

Objective: To examine the clinical and radiographic features in men and women in the Prospective Study of Outcomes in Ankylosing Spondylitis cohort, a large well-defined cross-sectional study of patients with AS, in order to understand the influence of gender in determining the severity of ankylosing spondylitis.

Methods: Extensive clinical assessments and spine radiographs were performed in 302 men and 100 women with AS of 20 years duration. Radiographs were scored using the Bath Ankylosing Spondylitis Radiographic Index Spine (BASRI-spine) score (range 2–12). Functional impairment was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S).

Results: Radiographic severity was worse among men. The unadjusted median BASRI-spine score for men was 10, compared with 6.5 for women (p<0.001). Functional disability, as measured by the BASFI and HAQ-S, was not different between men and women. However, after adjusting for radiographic spinal damage, women were found to report worse functioning than men at any given level of radiographic damage. Women had a slightly earlier age of disease onset; however, disease duration was identical in both groups. Women more frequently reported family histories of AS in first-degree relatives and were more likely to be treated with intra-articular steroids, sulphasalazine and prednisone.

Conclusions: Among patients with longstanding AS, men have more severe radiographic changes; findings of treatment differences suggest that women may have more peripheral arthritis. At any given level of radiographic damage, self-reported functional limitations were worse for women.

Abbreviations: AS, ankylosing spondylitis; BASFI, Bath Ankylosing Spondylitis Functional Index; BASRI, Bath Ankylosing Spondylitis Radiographic Index; BASRI-spine, Bath Ankylosing Spondylitis Radiographic Index Spine; HAQ-S, Health Assessment Questionnaire for the Spondyloarthropathies; HLA, human leucocyte antigen; PSOAS, Prospective Study of Outcomes in Ankylosing Spondylitis

This article has been cited by other articles:

				D. J. Pradeep, A. Keat, and K. Gaffney Predicting outcome in ankylosing spondylitis Rheumatology, July 1, 2008; 47(7): 942 - 945. [Full Text] [PDF]

				L S Gensler, M M Ward, J D Reveille, T J Learch, M H Weisman, and J C Davis Jr Clinical, radiographic and functional differences between juvenile-onset and adult onset ankylosing spondylitis: results from the PSOAS cohort Ann Rheum Dis, February 1, 2008; 67(2): 233 - 237. [Abstract] [Full Text] [PDF]