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Age at symptom onset in ankylosing spondylitis: is there a gender difference?
  1. Adrian Ciurea1,
  2. Almut Scherer2,
  3. Ulrich Weber3,
  4. Regula Neuenschwander4,
  5. Giorgio Tamborrini5,
  6. Pascale Exer6,
  7. Jürg Bernhard7,
  8. Peter M Villiger8,
  9. Rudolf Kissling3,
  10. Beat A Michel1,
  11. Daniel Stekhoven2
  12. on behalf of the rheumatologists of the Swiss Clinical Quality Management Program for axial spondyloarthritis
  1. 1 Department of Rheumatology, University Hospital, Zurich, Switzerland
  2. 2 Swiss Clinical Quality Management Foundation, Zurich, Switzerland
  3. 3 King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
  4. 4 University of Zurich, Zurich, Switzerland
  5. 5 Department of Rheumatology, Bethesda Hospital, Basel, Switzerland
  6. 6 Praxis Rheuma-Basel, Basel, Switzerland
  7. 7 Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn, Switzerland
  8. 8 Department of Rheumatology and Clinical Immunology, Inselspital, Bern, Switzerland
  1. Correspondence to Dr Adrian Ciurea, Department of Rheumatology, University Hospital Zurich, Gloriastrasse 25, Zurich CH-8091, Switzerland; adrian.ciurea{at}

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The impact of human leukocyte antigen (HLA)-B27 on the age at disease onset in patients with ankylosing spondylitis (AS) has consistently been shown in several cohorts.14 A potential gender difference with respect to age at symptom onset remains, however, controversial58 as the distribution of HLA-B27 within these populations is not known in all studies. While no sex differences with regard to disease onset were found in several cohorts from Europe,5 ,6 a later disease onset in men was reported in a North American investigation.7 We analysed this issue within the ongoing Swiss Clinical Quality Management cohort of patients with axial spondyloarthritis (axSpA).9 Ethics approval was given by the regional review boards. Informed consent was obtained from all patients.

From a total of 3046 spondyloarthritis patients recruited until June 2014, 2098 (1294 men, 804 women) were included in this analysis, as they fulfilled the Assessment in SpondyloArthritis International Society (ASAS) classification criteria, with the following minor modifications, as the cohort was initiated before …

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  • Contributors AC and DS designed the study. All investigators substantially contributed to the acquisition, analysis or interpretation of data. AC wrote the article and all coauthors revised the manuscript critically for important intellectual content. All authors finally approved the version to be published.

  • Funding This study was supported by a grant from the “Stiftung für Rheumaforschung” and by a grant from Abbvie AG. The SCQM Foundation was financially supported by the Swiss Society of Rheumatology, the Balgrist Foundation, the ARCO Foundation and by Abbvie, Bristol-Myers-Squibb, Merck Sharp & Dohme, Pfizer, Roche and UCB. Publication of this article was not contingent upon approval by the study sponsors.

  • Competing interests AC has received consulting and/or speaking fees from Abbvie, Merck Sharp & Dohme, Pfizer and UCB. UW has received honoraria from Abbvie for being a workshop convenor of the International Course of MRI in Spondyloarthritis and for contributing to a slide kit on spondyloarthritis. PE has received speaking fees from Abbvie.

  • Patient consent Obtained.

  • Ethics approval Ethics committee Kanton Zurich.

  • Provenance and peer review Not commissioned; externally peer reviewed.