Objectives To analyze gender-specific clinical features of patients with early axSpA.
Methods 150 patients with axSpA and <5 years duration of inflammatory back pain (ASAS criteria) were examined. Patients fulfilled ASAS criteria and were examined according to ASAS guidelines.
Results The Russian cohort of 150 axSpA patients included 59 (39.3%) men and 91 (60.7%) women. The women were significantly older: the median age of men was 25 (23-27), the age of women – 30 (26-34) (p=0.000001). Men were more often HLA B27 - positive (88% vs 75%; p=0.048). At the first examination, males more often than females had X-ray identified sacroiliitis (xSI): 65.5% vs 42.9% (p=0.007), and their AS was determined by the mNY criteria. Acute phase inflammation reactants (ESR and CRP) were significantly higher in men. Median ESR was 13 (6-32) mm/h in men, and 8 (5-15) mm/h – in women (p=0.02); median CRP 16. 7 (1.7-63.3) mg/L and 2.4 (0.9-7.8) mg/L, respectively (p=0.00004). Calcaneal enthesopathy (US examination) was significantly more often present in men (55.1%), than in women (32.1%; p=0.01).
There was no statistically significant difference between men and women in terms of BASDAI and ASDAS activity indexes, presence of peripheral arthritis, coxitis, dactilitis, MRI-sacroiliitis, MRI-spondylitis, low BMD, BASFI functional index, family SpA history.
Conclusions In the Russian cohort of axSpA patients, males seem to have a more aggressive disease than females: they have an earlier onset of axSpA, and earlier develop destructive changes in sacroiliac joints. Men are more often HLA B27 – positive. Calcaneal enthesopathy (US-examination) is more common in men. Acute phase reactants (ESR and CRP) are higher in men than in women. Functional BASFI status was similar in both genders.
Disclosure of Interest None declared