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Influence of Sex on Disease Severity in Patients with Rheumatoid Arthritis
LAURE GOSSEC, JUDITH BARO-RIBA, MARIE-CÉCILE BOZONNAT, JEAN-PIERRE DAURÈS, JACQUES SANY, JEAN-FRANÇOIS ELIAOU, and BERNARD COMBE
ABSTRACT. Methods. This was a retrospective, single-center study. We compared 133 male patients with 133 female patients presenting with RA and matched for disease duration. Data collection included demographic characteristics, pattern of joint involvement, extraarticular manifestations, medical treatment, and joint surgery. Biological measures, HLA genotypes, Larsen radiological scores on radiographs of hands and feet, and Health Assessment Questionnaire (HAQ) results were obtained. Results. Mean disease duration was 7.4 ± 6.9 years. Concerning clinical pattern of involvement, sicca syndrome was more frequent in women than in men (p = 0.0003). There were no significant differences concerning absence or presence of at least one disease associated gene (HLA-DRB1*01 or *04) in our patients; however, women more often carried 2 disease associated genes (21% vs 11%). No other difference in clinical, biological, or radiological indicators was noted between the 2 populations. Concerning treatment, there was no difference for large joint arthroplasties; female patients underwent significantly more distal joint arthrodesis, 6.7% vs 1.5% (p = 0.03); they were prescribed slightly more disease modifying drugs, 3.33 vs 2.83 (p = 0.04); and showed a trend toward more large joint arthrodesis, 15% vs 7.5% (p = 0.05), and metacarpophalangeal joint arthroplasties, 5.2% vs 0.7% (p = 0.08). Conclusion. When patients are matched for RA duration, sex has little effect on the disease pattern and severity, yet women undergo more distal joint surgery. (J Rheumatol 2005;32:1448-51) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Department of Rheumatology B, Cochin Hospital, AP-HP, René Descartes University, Paris; Service d'Immuno-Rhumatologie, Centre Hospitalier Universitaire Montpellier, INSERM U454, Montpellier; Institut Universitaire de Recherche Clinique, Montpellier; and Laboratoire d'Immunologie, Centre Hospitalier Universitaire Montpellier, INSERM U454, Montpellier, France. L. Gossec, MD, Department of Rheumatology B, René Cochin Hospital; J. Baro-Riba, MD; J. Sany, MD; B. Combe, MD, PhD, Service d'Immuno-Rhumatologie, Centre Hospitalier Universitaire Montpellier; M-C. Bozonnat, MD; J-P. Daurès, MD, PhD, Institut Universitaire de Recherche Clinique; J-F. Eliaou, MD, Laboratoire d'Immunologie, Centre Hospitalier Universitaire Montpellier. Address reprint requests to Dr. L. Gossec, Service de Rhumatologie B, Hardy B2, Hôpital Cochin, 27 rue du Faubourg St. Jacques, 75014 Paris, France. E-mail: laure.gossec@cch.aphp.fr Accepted for publication April 4, 2005. |