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Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage
  1. Monica Ahlmén (ahlmen.0317482476{at}telia.com)
  1. Department of Rheumatology, Sahlgrenska University Hospital/MS, Göteborg, Sweden
    1. Björn Svensson (bjosve{at}telia.com)
    1. Section of Rheumatology at the Institution of Clinical Science, University Hospital, Lund, Sweden
      1. Kristina Albertsson
      1. The Rheumatology unit at Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden
        1. Kristina Forslind
        1. Rheumatology section, Helsingborg hospital, Helsingborg, Sweden
          1. Ingiäld Hafström (ingiald.hafstrom{at}karolinska.se)
          1. The Rheumatology unit at Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden

            Abstract

            Objective: To evaluate gender differences in DAS28, HAQ and SOFI and to relate these scores to radiographic joint destruction.

            Methods: 549 patients with early RA (62% women) from the BARFOT study were included. At baseline, 1, 2 and 5 years DAS28, HAQ, SOFI and radiographs of hands and feet were performed. The radiographs were scored using the van der Heijde Sharp score.

            Results: In women DAS28 was significantly higher than in men due to higher scores for general health and tender joints. Likewise, HAQ and VAS pain were significantly higher in women. SOFI was worse in men during the first 2 years, depending on higher upper limb scores. Total Sharp score (TotSharp), erosion score and joint space narrowing did not differ between the sexes at any time point. DAS28 AUC correlated significantly with TotSharp at 5 years in both genders (r=0.316, r=0.313) mainly owing to swollen joints and ESR. SOFI AUC correlated significantly with TotSharp in women (r=0.135-0.220) but not in men.

            Conclusion: Despite similar degree of radiographic joint destruction women had, compared with men, worse scores for DAS28 and HAQ, possibly due to higher pain perception and less muscular strength and maybe because men overestimate their functional capacity.

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