RESEARCH - RA prognosis worse in women than men

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Rheumatoid arthritis prognosis worse in women than men

12/8/2006

By: Reuters Health

NEW YORK (Reuters Health), Dec 11 - Even when rheumatoid arthritis (RA) is

treated in the early stages of the disease, women have more severe disease

and lower remission rates than men, according to results of a study in

Sweden.

The goal of early treatment is to gain remission, with few signs of disease

progression, Dr. Bjorn Svensson, at University Hospital, Lund, and his

associates point out in their paper, in the ls of the Rheumatic

Diseases, published online ahead of print.

To assess the frequency of remission in male and female patients with RA,

the investigators followed patients from their initial presentation for up

to 5 years. Included were 689 patients undergoing treatment at six clinics

in southern Sweden.

At baseline, 64% of patients were women, age averaged 58 years, and mean

duration of disease was 6.2 months. According to physicians' assessments,

only 23% of subjects had low disease activity, and Health Assessment

Questionnaire scores indicated marked disability in some of the patients.

Prior to treatment, disease activity was similar between men and women.

The patients were treated with methotrexate, sulfasalazine, monotherapy or

combination therapy with other disease-modifying antirheumatic drugs, or

biological drugs.

At 18 months, the frequency of remission was 30.4% among women and 41.7%

among men. At 24 and 60 months, the rates of remission were 32.1% and 30.8%

among women, and 48.0% and 52.4% among men (p = 0.001 for all three

comparisons).

For the period between 18 and 60 months, documented remission at two or more

consecutive visits was noted for 13.8% of women and 30.3% of men (p =

0.001).

Moreover, " after 2 and 5 years of follow-up, most variables reflecting

disease activity clearly indicated that women had a more severe clinical

course of disease than men, " the investigators report.

In multiple regression analyses, male sex remained a major independent

predictor of remission.

Based on the low rates of remission, Dr. Svensson and his associates

recommend " reinforced vigilance in the frequency and quality of follow-up to

achieve optimum suppression of the inflammatory process of all patients,

regardless of sex. "

Last Updated: 2006-12-08 16:16:12 -0400 (Reuters Health)

Ann Rheum Dis 2006

http://www.auntminnie.com/index.asp?Sec=sup & Sub=wom & Pag=dis & ItemId=73934 & wf=1520

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