Gender characterization in a large series of Brazilian patients with spondyloarthritis

Gender characterization in a large series of Brazilian patients with spondyloarthritis

Author Carvalho, Hellen M. S. de Google Scholar
Bortoluzzo, Adriana B. Google Scholar
Goncalves, Celio R. Google Scholar
Braga da Silva, Jose Antonio Google Scholar
Ximenes, Antonio Carlos Google Scholar
Bertolo, Manoel B. Google Scholar
Ribeiro, Sandra L. E. Google Scholar
Keiserman, Mauro Google Scholar
Menin, Rita Google Scholar
Skare, Thelma L. Google Scholar
Carneiro, Sueli Google Scholar
Azevedo, Valderilio F. Google Scholar
Vieira, Walber P. Google Scholar
Albuquerque, Elisa N. Google Scholar
Bianchi, Washington A. Google Scholar
Bonfiglioli, Rubens Google Scholar
Campanholo, Cristiano Google Scholar
Costa, Izaias P. Google Scholar
Duarte, Angela P. Google Scholar
Gavi, Maria Bernadete O. Google Scholar
Kohem, Charles L. Google Scholar
Leite, Nocy H. Google Scholar
Lima, Sonia A. L. Google Scholar
Meirelles, Eduardo S. Google Scholar
Pereira, Ivanio A. Google Scholar
Pinheiro, Marcelo M. Autor UNIFESP Google Scholar
Polito, Elizandra Google Scholar
Resende, Gustavo G. Google Scholar
Rocha, Francisco Airton C. Google Scholar
Santiago, Mittermayer B. Google Scholar
Sauma, Maria de Fatima L. C. Google Scholar
Sampaio-Barros, Percival D. Google Scholar
Brazilian Registry Spondyloarthrit Google Scholar
Institution Hosp Base Dist Fed
Insper Inst Educ & Res
Universidade de São Paulo (USP)
Universidade de Brasília (UnB)
Hosp Geral Goiania
Universidade Estadual de Campinas (UNICAMP)
Univ Fed Amazonas
Pontificia Univ Catolica
Hosp Evangel Curitiba
Universidade Federal do Rio de Janeiro (UFRJ)
Universidade do Estado do Rio de Janeiro (UERJ)
Univ Fed Parana
Hosp Geral Fortaleza
Santa Casa Rio de Janeiro
Santa Casa São Paulo
Universidade Federal de Mato Grosso do Sul (UFMS)
Universidade Federal de Pernambuco (UFPE)
Univ Fed Espirito Santo
Univ Fed Rio Grande do Sul
Fac Med Souza Marques
Hosp Servidor Publ Estadual
Universidade Federal de Santa Catarina (UFSC)
Universidade Federal de São Paulo (UNIFESP)
Santa Casa Belo Horizonte
Universidade Federal de Minas Gerais (UFMG)
Univ Fed Ceara
Escola Med & Saude Publ
Fed Univ Para
Abstract An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. the aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded and the following disease indices were administered: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and Ankylosing Spondylitis Quality of Life (ASQoL). Ankylosing spondylitis (AS) was the most frequent disease in the group (65.4%), followed by psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), arthritis associated to inflammatory bowel disease (3.2%), and juvenile SpA (2.9%). the male-to-female ratio was 2.6:1 for the whole group and 3.6:1 for AS. the females were older (p<0.001) and reported shorter disease duration (p=0.002) than the male patients. the female gender was positively associated to peripheral SpA (p<0.001), upper limb arthritis (p<0.001), dactylitis (p=0.011), psoriasis (p<0.001), nail involvement (p<0.001), and family history of SpA (p=0.045) and negatively associated to pure axial involvement (p< 0.001), lumbar inflammatory pain (p=0.042), radiographic sacroiliitis (p<0.001), and positive HLA-B27 (p=0.001). the number of painful (p<0.001) and swollen (p=0.006) joints was significantly higher in the female gender, who also achieved higher BASDAI (p<0.001), BASFI (p=0.073, trend), MASES (p=0.019), ASQoL (p=0.014), and patient's global assessment (p=0.003) scores, whereas the use of nonsteroidal anti-inflammatory drugs (p<0.001) and biological agents (p=0.003) was less frequent in the female gender. Moreover, BASRI values were significantly lower in females (p<0.001). the female gender comprised one third of SpA patients in this large cohort and exhibited more significant peripheral involvement and less functional disability, despite higher values in disease indices.
Keywords Gender
Prognosis
Spondyloarthritis
Language English
Sponsor Wyeth/Pfizer Brazil
Federico Foundation, Switzerland
Date 2012-04-01
Published in Clinical Rheumatology. London: Springer London Ltd, v. 31, n. 4, p. 687-695, 2012.
ISSN 0770-3198 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 687-695
Origin http://dx.doi.org/10.1007/s10067-011-1890-3
Access rights Closed access
Type Article
Web of Science ID WOS:000303449200014
URI http://repositorio.unifesp.br/handle/11600/34749

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