Background Systemic sclerosis (SSc) has a female predominance, however, little is understood about the effect of sex on SSc manifestations and survival.
Objectives The objectives of our study were to evaluate differences in disease manifestations, and survival rates between males and females with SSc.
Methods A retrospective cohort study of EUSTAR center 096 was conducted to evaluate sex-based differences in disease manifestations and survival. A complete baseline evaluation of all patients was done according to MEDS evaluation sheets. A complete follow-up was done every year. All calculations were performed with SPSS Statistics 20.0. Student t-test or Mann-Whitney test and chi-square test were used to evaluate differences for variables. Pearson's bivariate correlation or Spearman's rank correlation coefficient were used to evaluate the association between evaluated variables. The values of r>0.5 and p<0.05 were considered statistically significant.
Results 90 SSc patients (82 females and 8 males) were followed between JAN 2010 – JAN 2015, with a female:male ratio of 10,25:1. Male patients with systemic sclerosis are younger (48.63±13.46 years compared to 55.63±11.51 years in females), have a shorter disease duration (76±78.13 months compared to 124.11±86.6 months in females), higher Rodnan skin scores (12.38±7.46 compared to 8.85±5.14 in females) with more frequent diffuse skin involvement (62,5% compared to 52,38% in females), develop more frequent digital ulcers (50% compared to 40,29% in females), pulmonary fibrosis (62,5% compared to 35,82% in females), pulmonary arterial hypertension (37,5% compared to 17,91% in females) and have higher Medsger severity score (8.75±3.28 compared to 6.87±3.06); yet none of the above reached statistical significance. Still, activity score seems to be higher in male patients (5,62±3,00 compared to 3,53±1,87, p=0,007). Mortality rates at 5 years was 50% for men compared to 8,95% for women, close to statistical significance (p=0,061). Male sex was associated with increased risk of scleroderma renal crisis (p=0.001).
Conclusions The differential effect of disease between sexes is small, yet males have increased risk of scleroderma renal crisis compared to females with SSc.
Hussein H, Lee P, Chau C, Johnson SR. The effect of male sex on survival in systemic sclerosis.J Rheumatol. 2014;41(11):2193-200
Disclosure of Interest None declared