The influence of sex on RA: a prospective study of onset and outcome after 2 years

[Guest guest]

J Rheumatol. 2004 Feb;31(2):214-22.

The influence of sex on rheumatoid arthritis: a prospective study of

onset and outcome after 2 years.

Tengstrand B, Ahlmen M, Hafstrom I.

Department of Rheumatology, Karolinska Institutet at Huddinge University

Hospital, Stockholm, Sweden.

OBJECTIVE: This prospective study analyzed influence of patient's sex on

early rheumatoid arthritis (RA) within one year of disease onset and

after 2 years' followup. METHODS: A total of 844 consecutive patients,

538 women, with RA of less than 12 months were studied. Standardized

clinical and radiographic assessments were performed at study entry and

after 2 years. The association of several variables at study entry with

the outcome variables Disease Activity Score (DAS28), functional

disability measured by the Health Assessment Questionnaire (HAQ), and,

in 390 patients, Larsen score at the 2-year followup were analyzed in

men and women separately. RESULTS: At study entry the women were younger

compared with the men and the sexes showed different age distributions.

The women had higher DAS28 and HAQ scores. However, women below 50 years

of age at study entry had milder disease than older women and close to

that of men. At 2-year followup the women still had higher DAS28 and HAQ

scores compared to men, who had achieved remission in a higher

frequency. Larsen score showed no sex difference either at study entry

or after 2 years. Presence of rheumatoid factor (RF) was associated with

lower age at study entry and higher DAS28 at followup in men only.

Higher DAS28 and HAQ scores at entry were more strongly correlated with

severe disease at followup in women than in men. Presence of the " shared

epitope " was not associated with age or the outcome variables DAS28 and

Larsen score in either sex.

CONCLUSION: The disease phenotype in early RA was significantly

different between men and women, particularly concerning age, disease

activity, and functional capacity. There were differences between the

sexes concerning early disease characteristics associated with outcome

at 2 years of followup.

PMID: 14760787

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org