Background The clinical presentation of ankylosing spondylitis (AS) can be different between genders.
Objectives To investigate differences in clinical assessments of disease activity, physical function and quality of life between male and female AS patients before the start of TNF-α inhibitors and after 2 years of follow-up.
Methods Patients from the Groningen Leeuwarden AS (GLAS) cohort who started TNF-α inhibitors because of active disease with baseline and 2-year follow-up visits were included. Disease activity was assessed using the BASDAI, ASDAS, CRP, and patient GDA. Physical function and quality of life were assessed using the BASFI and ASQoL, respectively.
Results Of the 220 included AS patients with active disease, 69% were male, 78% HLA-B27 positive, mean age was 43±12 years, and median duration of symptoms 16 years (IQR 8–25). Patient characteristics were comparable between men and women.
At baseline, female patients with AS experienced significantly higher disease activity according to BASDAI, ASDAS, and patient GDA compared to male patients. Baseline CRP levels were comparable between genders. Furthermore, physical function (BASFI) and quality of life (ASQoL) were significantly worse in female patients (Table 1).
After staring TNF-α inhibitors, all clinical assessments improved significantly during 2 years of follow-up. The change over 2 years was comparable between male and female patients for all measures of disease activity, physical function, and quality of life (Table 1). After 2 years, significantly less women were still using their first TNF-α inhibitor (53% vs. 81%) and significantly more women had switched to a second TNF-α inhibitor (31% vs. 15%).
Conclusions In this large cohort of AS patients with active disease, cross-sectional analysis showed that women experience higher disease activity and worse physical function and quality of life on self-reported assessments than men. Longitudinal analysis after starting TNF-α inhibitors showed that the changes in clinical assessments over 2 years were comparable between genders.
Acknowledgement The GLAS cohort was supported by an unrestricted grant from Pfizer. Pfizer had no role in the design, conduct, interpretation, or publication of this study.
Disclosure of Interest B. van der Slik: None declared, S. Arends Grant/research support from: Pfizer, E. Brouwer Grant/research support from: Pfizer, F. Wink Consultant for: Abbvie, M. Efde: None declared, H. Bootsma: None declared, F. Maas: None declared, A. Spoorenberg Grant/research support from: Abbvie, Pfizer, UCB, Consultant for: Abbvie, Pfizer, MSD, UCB, Novartis