RESEARCH - Influence of gender on assessments of disease activity and function in early RA in relation to radiographic joint damage

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Ann Rheum Dis. Published Online First: 21 January 2009.

doi:10.1136/ard.2008.102244

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Concise Report

Influence of gender on assessments of disease activity and function in

early rheumatoid arthritis in relation to radiographic joint damage

Ahlmén 1, Björn Svensson 2, a Albertsson 3, a

Forslind 4 and Ingiäld Hafström 3*

1 Department of Rheumatology, Sahlgrenska University Hospital/MS,

Göteborg, Sweden

2 Section of Rheumatology at the Institution of Clinical Science,

University Hospital, Lund, Sweden

3 The Rheumatology unit at Karolinska Institute at Karolinska

University Hospital Huddinge, Stockholm, Sweden

4 Rheumatology section, Helsingborg hospital, Helsingborg, Sweden

Abstract

Objective: To evaluate gender differences in DAS28, HAQ and SOFI and

to relate these scores to radiographic joint destruction.

Methods: 549 patients with early RA (62% women) from the BARFOT study

were included. At baseline, 1, 2 and 5 years DAS28, HAQ, SOFI and

radiographs of hands and feet were performed. The radiographs were

scored using the van der Heijde Sharp score.

Results: In women DAS28 was significantly higher than in men due to

higher scores for general health and tender joints. Likewise, HAQ and

VAS pain were significantly higher in women. SOFI was worse in men

during the first 2 years, depending on higher upper limb scores. Total

Sharp score (TotSharp), erosion score and joint space narrowing did

not differ between the sexes at any time point. DAS28 AUC correlated

significantly with TotSharp at 5 years in both genders (r=0.316,

r=0.313) mainly owing to swollen joints and ESR. SOFI AUC correlated

significantly with TotSharp in women (r=0.135-0.220) but not in men.

Conclusion: Despite similar degree of radiographic joint destruction

women had, compared with men, worse scores for DAS28 and HAQ, possibly

due to higher pain perception and less muscular strength and maybe

because men overestimate their functional capacity.

http://ard.bmj.com/cgi/content/abstract/ard.2008.102244v1?papetoc

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