Background It’s a potentially serious illness that can cause significant functional disability and ultimately axial fusion.Historically it has been considered a disease that mainly affects men,but recent studies have shown that a significant % of patients with ankylosing spondylitis(AS) are women1-4On the other hand the severity of the disease in women isn’t as low as classically been considered5
Objectives Set the differential characteristics by sex and time of disease progression in patients diagnosed with AS assisted in rheumatology consultations throughout Spain, including Regisponser as well as diagnostic and therapeutic implications that this entails
Methods Transversal and observational study of 1514 patients with AS incluyed in the Spanish Registry of SpA(Regisponser). In each patient were evaluated and recorded the demographics, epidemiology, geriatric,clinical,laboratory,radiological and therapeutic protocol under Regisponser that make up the Minimum Basic identifying the disease.Physical function was assessed by BASFI.Clinical activity using ESR(erythrocyte sedimentation rate),CRP(C Reactive Protein)and BASDAI6.Each patient underwent anteroposterior(AP)pelvic radiograph,AP and lateral lumbar spine and cervical spine lateral and scored according to the index-Spinal BASRI7,which measures structural damage.
Results Of the 1514 patients screened, 1131 were men. Among both groups we found significant differences in the time course of the disease, which was lower in the group of women. As for the existence of a history of spondylitis among first-degree relatives, we found that familial forms were more common among women, was also higher in women the mean BASDAI score, regardless of time of evolution. By contrast, the improvement in pain with taking NSAIDs was higher for men, and the radiological severity, both significantly
Conclusions The data obtained in our study in the Spanish population, we can conclude that differences in clinical and radiological manifestations of AS according to sex. We found that men show more structural damage compared with women with similar time course of the disease, it also increases the damage to the temporal evolution of the disease regardless of gender. Although radiographic damage in women is lower, the degree of activity is higher in this group. These data suggest that the phenotype of AS differs between the sexes can influence the diagnostic and therapeutic choice.
Gran JT et al.A clinical comparison between males and females with AS.J Rheumatol 1985;12:126–9.
Hill HFH et al.Clinical diagnosis of AS in women and relation to presence of HLA-B27. Ann Rheum Dis 1976;35:267–70.
Carbone LD et al. AS in Rochester, Minnesota, 1935–1989: is the epidemiology changing? Arthritis Rheum 1992;35:1476–82.
Gomez KS et al. Juvenile onset AS more girls than we thought.J Rheumatol 1997;24:735–7.
Wonuk Lee, et al.Are there gender differences in severity of AS.Results from the PSOAS cohort.Ann Rheum Dis 2007;66:633–638. doi: 10.1136/ard.2006.060293.
Garrett S et al. (1994) A new approach to defining disease status in AS:the Bath Ankylosing Spondylitis Disease Actiity Index. J Rheumatolol 21: 2286-2291
Calin A et al. A new dimension to outcome:application of the Bath ankylosing spondylitis radiology index.J Rheumatol 1999;26:988–92
Disclosure of Interest None Declared