rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2025-490-495rsp-3809Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHАксиальный спондилоартрит у мужчин и женщинAxial spondyloarthritis in men and womenhttps://orcid.org/0000-0002-6354-7244ИльиныхЕ. В.IlinykhE. V.

Ильиных Екатерина Валериевна 

115522, Москва, Каширское шоссе, 34а

Ekaterina V. Ilinykh 

115522, Moscow, Kashirskoye Highway, 34A

kater1104@yahoo.comhttps://orcid.org/0000-0002-1771-6246ДубининаТ. В.DubininaT. V.

115522, Москва, Каширское шоссе, 34а

Tatiana V. Dubinina 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-0337-453XСаблинаА. О.SablinaA. O.

115522, Москва, Каширское шоссе, 34а

Anastasiya O. Sablina 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-2246-686XАгафоноваЕ. М.AgafonovaE. M.

115522, Москва, Каширское шоссе, 34а

Ekaterina M. Agafonova 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-2486-8798СахароваК. В.SakharovaK. V.

115522, Москва, Каширское шоссе, 34а

Ksenia V. Sakharova 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-3106-3296ДёминаА. Б.DeminaA. B.

115522, Москва, Каширское шоссе, 34а

Anastasiya B. Demina 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-0291-524XАндриановаИ. А.AndrianovaI. A.

115522, Москва, Каширское шоссе, 34а

Irina A. Andrianova 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-4285-0869ГлуховаС. И.GlukhovaS. I.

115522, Москва, Каширское шоссе, 34а

Svetlana I. Glukhova 

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-3195-5187ЭрдесШ. Ф.ErdesSh. F.

115522, Москва, Каширское шоссе, 34а

Shandor F. Erdes 

115522, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202501112025635490495Copyright © Ильиных Е.В., Дубинина Т.В., Саблина А.О., Агафонова Е.М., Сахарова К.В., Дёмина А.Б., Андрианова И.А., Глухова С.И., Эрдес Ш.Ф., 20252025Ильиных Е.В., Дубинина Т.В., Саблина А.О., Агафонова Е.М., Сахарова К.В., Дёмина А.Б., Андрианова И.А., Глухова С.И., Эрдес Ш.Ф.Ilinykh E.V., Dubinina T.V., Sablina A.O., Agafonova E.M., Sakharova K.V., Demina A.B., Andrianova I.A., Glukhova S.I., Erdes S.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3809

Работы последних десятилетий изменили представление о том, что аксиальный спондилоартрит (аксСпА) является исключительно «мужской» болезнью. Однако в настоящее время при решении вопроса о дальнейшей тактике терапии половые различия в течении заболевания и ответе на лечение не учитываются.Цель исследования – изучить половые различия в показателях активности заболевания у пациентов с аксиальным спондилоартритом.Материалы и методы. В исследование было включено 108 пациентов, которые удовлетворяли критериям аксСпА 2009 г., разработанным ASAS (Assessment of SpondyloArthritis International Society), или модифицированным Нью-Йоркским критериям анкилозирующего спондилита (АС) 1984 г. Средний возраст пациентов на момент включения в исследование составил 35,4±10,8 года; большинство пациентов были мужчинами (n=62 – 57,4%). Критериям АС соответствовали 67,2% женщин и 88,5% мужчин. Остальным пациентам был диагностирован нерентгенологический аксСпА.Результаты и обсуждение. Длительность заболевания у пациентов разного пола статистически значимо не различалась (р=0,3), ее медиана составляла 60,0 [24,0; 96,0] мес. у мужчин и 42,0 [21,8; 84,0] мес. у женщин. HLA-B27 обнаружен у 36 (78,3%) женщин и у 55 (88,7%) мужчин. У женщин чаще (р=0,048), чем у мужчин, диагностировали артрит (в 37 (80,4%) и 39 (62,9%) случаях соответственно), а также дактилит (в 15 (32,6%) и 8 (12,9%) случаях соответственно; р=0,01). По частоте других клинических проявлений аксСпА различий между мужчинами и женщинами не выявлено. Также не обнаружено различий по индексам BASFI (Bath Ankylosing Spondylitis Functional Index), MASES (Maastrich Ankylosing Spondylitis Enthesitis Score) и по всем доменам индекса BASMI (Bath Ankylosing Spondylitis Metrology Index). У мужчин уровень C-реактивного белка был статистически значимо выше, чем у женщин (р=0,03). При этом активность заболевания по индексу BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), а также показатели оценки боли и общей оценки самочувствия по числовой рейтинговой шкале у женщин исследуемой группы были выше, чем у мужчин. Среднее значение тревоги по HADS (Hospital Anxiety and Depression Scale) у женщин также было выше (р=0,01), чем у мужчин; его медиана составляла 9,0 [6,0; 10,0] и 5,0 [2,0; 8,0] соответственно. Оценка депрессии по HADS между группами статистически значимо не различалась (р=0,3); медиана составила 5,5 [3,0; 6,0] и 3 [1,0; 5,6] соответственно.Выводы. Выявленная клиническая гетерогенность проявлений аксСпА у мужчин и женщин, особенности в оценке боли пациентами разного пола позволяют утверждать, что пол оказывает влияние на интерпретацию активности заболевания. Необходимы дальнейшие исследования, посвященные изучению половых различий у пациентов с аксСпА для оптимизации подходов к лечению и оценке его эффективности.

The work of recent decades has changed the idea that axial spondylitis (axSpA) is an exclusively “male” disease. However, at present, when deciding on further treatment tactics, gender differences in the course of the disease and response to treatment are not taken into account.The aim – to study gender differences in disease activity indices in patients with axial spondylitis.Material and methods. The study included 108 patients who met the 2009 ASAS (Assessment of SpondyloArthritis International Society) criteria for axSpA or the modified New York criteria for ankylosing spondylitis (AS) of 1984. The mean age of patients at inclusion in the study was 35.4±10.8 years, most of them were men – 62 (57.4%). The AS criteria were met by 67.2% of women and 88.5% of men. The remaining patients were diagnosed with non-radiographic axSpA.Results and discussion. The duration of the disease did not differ between patients of different sexes (p=0.3): 60.0 [24.0; 96.0] months in men and 42.0 [21.8; 84.0] months in women. HLA-B27 antigen positivity was detected in 36 (78.3%) women and 55 (88.7%) men. Women were more often (p=0.048) diagnosed with arthritis than men: 37 (80.4%) and 39 (62.9%), as well as dactylitis (p=0.01): 15 (32.6%) and 8 (12.9%), respectively. No differences were found between men and women in the frequency of other extraskeletal and extraaxial manifestations of axSpA. Also, no differences were found in the BASFI (Bath Ankylosing Spondylitis Functional Index), MASES (Maastrich Ankylosing Spondylitis Enthesitis Score) indices and in all domains of the BASMI (Bath Ankylosing Spondylitis Metrology Index) index. In men, the C-reactive protein level was significantly higher than in women (p=0.03). At the same time, the disease activity according to the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) index, as well as the patient’s pain assessment indicators, global assessment of general well-being according to the numeric rating scale in women of the study group were higher than in men. The average anxiety value according to the HADS (Hospital Anxiety and Depression Scale) scale was higher in women (p=0.01) than in men – 9.0 [6.0; 10.0] and 5.0 [2.0; 8.0], respectively. The average depression value according to the HADS scale did not differ between the groups (p=0.3): 5.5 [3.0; 6.0] and 3 [1.0; 5.6], respectively.Conclusions. The revealed clinical heterogeneity of axSpA manifestations in men and women, the peculiarities in pain assessment by patients of different genders, allow us to state that gender influences the interpretation of disease activity. Further studies are needed to study gender differences in patients with axSpA to optimize treatment approaches and assess its effectiveness.

аксиальный спондилоартританкилозирующий спондилитактивностьBASDAIASDAS-СРБмужской полженский полaxial spondyloarthritisankylosing spondylitisactivityBASDAIASDAS-CRPmalefemaleИсследование выполнено в рамках фундаментальной темы РК 125020501435-8 «Эволюция аксиальных спондилоартритов на основе комплексного динамического изучения молекулярно-биологических, молекулярно-генетических, клинико-визуализационных факторов прогрессирования заболевания, качества жизни, коморбидности и таргетной инновационной терапии».ReferencesLiu KA, Mager NA. Women’s involvement in clinical trials: Historical perspective and future implications. Pharm Pract (Granada). 2016;14(1):708. doi: 10.18549/PharmPract.2016.01.708Liu KA, Mager NA. Women’s involvement in clinical trials: Historical perspective and future implications. Pharm Pract (Granada). 2016;14(1):708. doi: 10.18549/PharmPract.2016.01.708Rudwaleit M. New approaches to diagnosis and classification of axial and peripheral spondyloarthritis. Curr Opin Rheumatol. 2010;22(4):375-380. doi: 10.1097/bor.0b013e32833ac5cc.0Rudwaleit M. New approaches to diagnosis and classification of axial and peripheral spondyloarthritis. Curr Opin Rheumatol. 2010;22(4):375-380. doi: 10.1097/bor.0b013e32833ac5cc.0Эрдес ШФ, Румянцева ДГ, Смирнов АВ. Оценка прогрессирования аксиального спондилоартрита на ранних стадиях болезни в реальной клинической практике: возможности использования суммарного счета рентгенологического сакроилеита. Научно-практическая ревматология. 2018;56(4):461- 465. doi: 10.14412/1995-4484-2018-461-465Erdes ShF, Rumyantseva DG, Smirnov AV. Evaluation of the progression of axial spondyloarthritis in the early stages of the disease in real clinical practice: The possibilities of using the summary score of radiographic sacroiliitis. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2018;56(4):461-465 (In Russ.). doi: 10.14412/1995-4484-2018-461-465Baumberger H, Khan MS. Gradual progressive change to equal prevalence of ankylosing spondylitis among males and females in Switzerland: Data from the Swiss Ankylosing Spondylitis Society (SVMB). Ann Rheum Dis. 2017;76:929. doi: 10.1136/annrheumdis-2017-eular.3961Baumberger H, Khan MS. Gradual progressive change to equal prevalence of ankylosing spondylitis among males and females in Switzerland: Data from the Swiss Ankylosing Spondylitis Society (SVMB). Ann Rheum Dis. 2017;76:929. doi: 10.1136/annrheumdis-2017-eular.3961Sieper J, van der Heijde D, Review nonradiographic axial spondyloarthritis: New definition of an old disease? Arthritis Rheum. 2013;65(3):543-551. doi: 10.1002/art.37803Sieper J, van der Heijde D, Review nonradiographic axial spondyloarthritis: New definition of an old disease? Arthritis Rheum. 2013;65(3):543-551. doi: 10.1002/art.37803Эрдес ШФ, Дубинина ТВ, Румянцева ОА, Дёмина АБ, Губарь ЕЕ, Румянцева ДГ. Эволюция аксиального спондилоартрита за 12 месяцев наблюдения когорты КоРСаР. Научно-практическая ревматология. 2016;54(Прил 1):55-59 doi: 10.14412/1995-4484-2016-1S-55-59Erdes ShF, Dubinina TV, Rumyantseva OA, Dyomina AB, Gubar EE, Rumyantseva DG. The evolution of axial spondyloarthritis during 12-month follow-up study of a CoRSaR cohort. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2016;54(Suppl 1):55- 59 (In Russ.). doi: 10.14412/1995-4484-2016-1S-55-59Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recentonset axial spondyloarthritis: Results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013;65(9):1482- 1489. doi: 10.1002/acr.22001Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recentonset axial spondyloarthritis: Results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013;65(9):1482- 1489. doi: 10.1002/acr.22001Cunha RN, Vieira-Sousa E, Khmelinskii N, Ávila-Ribeiro P, Couto M, Seixas MI, et al. Sex differences in axial spondyloarthritis: Data from a Portuguese spondyloarthritis cohort. ARP Rheumatol. 2022;1(1):42-48.Cunha RN, Vieira-Sousa E, Khmelinskii N, Ávila-Ribeiro P, Couto M, Seixas MI, et al. Sex differences in axial spondyloarthritis: Data from a Portuguese spondyloarthritis cohort. ARP Rheumatol. 2022;1(1):42-48.Cortes A, Maksymowych WP, Wordsworth BP, Inman RD, Danoy P, Rahman P, et al.; Association study of genes related to bone formation and resorption and the extent of radiographic change in ankylosing spondylitis. Ann Rheum Dis. 2015;74(7):1387- 1393. doi: 10.1136/annrheumdis-2013-204835Cortes A, Maksymowych WP, Wordsworth BP, Inman RD, Danoy P, Rahman P, et al.; Association study of genes related to bone formation and resorption and the extent of radiographic change in ankylosing spondylitis. Ann Rheum Dis. 2015;74(7):1387- 1393. doi: 10.1136/annrheumdis-2013-204835Rusman T, John MB, van der Weijden MAC, Boden BJH, van der Bijl CMA, Bruijnen STG, et al. Presence of active MRI lesions in patients suspected of non-radiographic axial spondyloarthritis with high disease activity and chance at conversion after a 6-month follow-up period. Clin Rheumatol. 2020;39(5):1521- 1529. doi: 10.1007/s10067-019-04885-8Rusman T, John MB, van der Weijden MAC, Boden BJH, van der Bijl CMA, Bruijnen STG, et al. Presence of active MRI lesions in patients suspected of non-radiographic axial spondyloarthritis with high disease activity and chance at conversion after a 6-month follow-up period. Clin Rheumatol. 2020;39(5):1521- 1529. doi: 10.1007/s10067-019-04885-8Ward MM, Hendrey MR, Malley JD, Learch TJ, Davis JC Jr, Reveille JD, et al. Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis. Arthritis Rheum. 2009;61(7):859-866. doi: 10.1002/art.24585Ward MM, Hendrey MR, Malley JD, Learch TJ, Davis JC Jr, Reveille JD, et al. Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis. Arthritis Rheum. 2009;61(7):859-866. doi: 10.1002/art.24585Lee W, Reveille JD, Davis JC Jr, Learch TJ, Ward MM, Weisman MH. Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis. 2007;66(5):633-638. doi: 10.1136/ard.2006.060293Lee W, Reveille JD, Davis JC Jr, Learch TJ, Ward MM, Weisman MH. Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis. 2007;66(5):633-638. doi: 10.1136/ard.2006.060293Rudwaleit M, Haibel H, Baraliakos X, Listing J, Märker-Hermann E, Zeidler H, et al. The early disease stage in axial spondylarthritis: Results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60(3):717-727. doi: 10.1002/art.24483Rudwaleit M, Haibel H, Baraliakos X, Listing J, Märker-Hermann E, Zeidler H, et al. The early disease stage in axial spondylarthritis: Results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60(3):717-727. doi: 10.1002/art.24483Cansu DU, Calışır C, Savaş Yavaş U, Kaşifoğlu T, Korkmaz C. Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol. 2011;30(4):557-562. doi: 10.1007/s10067-010-1665-2Cansu DU, Calışır C, Savaş Yavaş U, Kaşifoğlu T, Korkmaz C. Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol. 2011;30(4):557-562. doi: 10.1007/s10067-010-1665-2Mease PJ, McLean RR, Dube B, Liu M, Rebello S, Glynn M, et al. Comparison of men and women with axial spondyloarthritis in the US-based Corrona psoriatic arthritis/spondyloarthritis registry. J Rheumatol. 2021;48(10):1528-1536. doi: 10.3899/jrheum.201549Mease PJ, McLean RR, Dube B, Liu M, Rebello S, Glynn M, et al. Comparison of men and women with axial spondyloarthritis in the US-based Corrona psoriatic arthritis/spondyloarthritis registry. J Rheumatol. 2021;48(10):1528-1536. doi: 10.3899/jrheum.201549Almousa S, Alshamaa N, Wannous H, Khder K, Qasem H. Gender-related differences in axial spondyloarthritis (axSpA) patients. Egypt Rheumatol. 2023;45(1):13-16. doi: 10.1016/j.ejr.2022.08.003Almousa S, Alshamaa N, Wannous H, Khder K, Qasem H. Gender-related differences in axial spondyloarthritis (axSpA) patients. Egypt Rheumatol. 2023;45(1):13-16. doi: 10.1016/j.ejr.2022.08.003Landi M, Maldonado-Ficco H, Perez-Alamino R, Maldonado-Cocco JA, Citera G, Arturi P, et al.; RESPONDIA Group. Fundación Reumatológica Argentina “Dr. Osvaldo García Morteo. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an Iberoamerican Spondyloarthritis Cohort. Medicine (Baltimore). 2016;95(51):e5652. doi: 10.1097/MD.0000000000005652Landi M, Maldonado-Ficco H, Perez-Alamino R, MaldonadoCocco JA, Citera G, Arturi P, et al.; RESPONDIA Group. Fundación Reumatológica Argentina “Dr. Osvaldo García Morteo. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an Iberoamerican Spondyloarthritis Cohort. Medicine (Baltimore). 2016;95(51):e5652. doi: 10.1097/MD.0000000000005652Feldtkeller E, Bruckel J, Khan MA. Scientific contributions of ankylosing spondylitis patient advocacy groups. Curr Opin Rheumatol. 2000;12(4):239-247. doi: 10.1097/00002281-200007000-00002Feldtkeller E, Bruckel J, Khan MA. Scientific contributions of ankylosing spondylitis patient advocacy groups. Curr Opin Rheumatol. 2000;12(4):239-247. doi: 10.1097/00002281-200007000-00002Di Giuseppe D, Lindström U, Aaltonen K, Relas H, Provan S, Gudbjornsson B, et al. The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries. Rheumatology (Oxford). 2022;61(9):3647-3656. doi: 10.1093/rheumatology/keab946Di Giuseppe D, Lindström U, Aaltonen K, Relas H, Provan S, Gudbjornsson B, et al. The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries. Rheumatology (Oxford). 2022;61(9):3647-3656. doi: 10.1093/rheumatology/keab946Benavent D, Capelusnik D, Ramiro S, Molto A, López-Medina C, Dougados M, et al. Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASASperSpA study. RMD Open. 2022;8(2):e002514. doi: 10.1136/rmdopen-2022-002514Benavent D, Capelusnik D, Ramiro S, Molto A, López-Medina C, Dougados M, et al. Does gender influence outcome measures similarly in patients with spondyloarthritis? Results from the ASASperSpA study. RMD Open. 2022;8(2):e002514. doi: 10.1136/rmdopen-2022-002514Webers C, Essers I, Ramiro S, Stolwijk C, Landewé R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: Long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology (Oxford). 2016;55(3):419-428. doi: 10.1093/rheumatology/kev340Webers C, Essers I, Ramiro S, Stolwijk C, Landewé R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: Long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology (Oxford). 2016;55(3):419-428. doi: 10.1093/rheumatology/kev340Fakih O, Desmarets M, Martin B, Prati C, Monnet E, Verhoeven F, et al. Difficult-to-treat axial spondyloarthritis is associated with psoriasis, peripheral involvement and comorbidities: Results of an observational nationwide study. RMD Open. 2023;9(4):e003461. doi: 10.1136/rmdopen-2023-003461Fakih O, Desmarets M, Martin B, Prati C, Monnet E, Verhoeven F, et al. Difficult-to-treat axial spondyloarthritis is associated with psoriasis, peripheral involvement and comorbidities: Results of an observational nationwide study. RMD Open. 2023;9(4):e003461. doi: 10.1136/rmdopen-2023-003461Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE. Gender differences in axial spondyloarthritis: Women are not so lucky. Curr Rheumatol Rep. 2018;20(6):35. doi: 10.1007/s11926-018-0744-2Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE. Gender differences in axial spondyloarthritis: Women are not so lucky. Curr Rheumatol Rep. 2018;20(6):35. doi: 10.1007/s11926-018-0744-2Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361-368. doi: 10.1002/art.1780270401Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361-368. doi: 10.1002/art.1780270401Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: A guide to assess spondyloarthritis. Ann Rheum Dis. 2009;68(Suppl 2):ii1-ii44. doi: 10.1136/ard.2008.104018Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, BurgosVargas R, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: A guide to assess spondyloarthritis. Ann Rheum Dis. 2009;68(Suppl 2):ii1-ii44. doi: 10.1136/ard.2008.104018Дубинина ТВ, Гайдукова ИЗ, Годзенко АА, Лапшина СА, Ребров АП, Румянцева ОА, и др. Рекомендации по оценке активности болезни и функционального состояния больных анкилозирующим спондилитом в клинической практике. Научно-практическая ревматология. 2017;55(4):344- 350. doi: 10.14412/1995-4484-2017-344-3Dubinina TV, Gaidukova IZ, Godzenko AA, Lapshina SA, Rebrov AP, Rumyantseva OA, et al. Guidelines for the assessment of disease activity and functional status in patients with ankylosing spondylitis in clinical practice. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2017;55(4):344-350 (In Russ.)]. doi: 10.14412/1995-4484-2017-344-3Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370. doi: 10.1111/j.1600-0447.1983.tb09716.xZigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370. doi: 10.1111/j.1600-0447.1983.tb09716.xBjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52(2):69-77. doi: 10.1016/s0022-3999(01)00296-3Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52(2):69-77. doi: 10.1016/s0022-3999(01)00296-3Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023;82(1):19-34. doi: 10.1136/ard-2022-223296Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023;82(1):19-34. doi: 10.1136/ard-2022-223296Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA, et al. 2019 update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Care Res (Hoboken). 2019;71(10):1285-1299. doi: 10.1002/acr.24025Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA, et al. 2019 update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Care Res (Hoboken). 2019;71(10):1285-1299. doi: 10.1002/acr.24025Seo MR, Yeo J, Park JW, Lee YA, Lee JH, Kang EH, et al. Korean treatment recommendations for patients with axial spondyloarthritis. J Rheum Dis. 2023;30(3):151-169. doi: 10.4078/jrd.2023.0025Seo MR, Yeo J, Park JW, Lee YA, Lee JH, Kang EH, et al. Korean treatment recommendations for patients with axial spondyloarthritis. J Rheum Dis. 2023;30(3):151-169. doi: 10.4078/jrd.2023.0025Tam LS, Wei JC, Aggarwal A, Baek HJ, Cheung PP, Chiowchanwisawakit P, et al. 2018 APLAR axial spondyloarthritis treatment recommendations. Int J Rheum Dis. 2019;22(3):340-356. doi: 10.1111/1756-185X.13510Tam LS, Wei JC, Aggarwal A, Baek HJ, Cheung PP, Chiowchanwisawakit P, et al. 2018 APLAR axial spondyloarthritis treatment recommendations. Int J Rheum Dis. 2019;22(3):340-356. doi: 10.1111/1756-185X.13510Wendling D, Hecquet S, Fogel O, Letarouilly JG, Verhoeven F, Pham T, et al. 2022 French Society for Rheumatology (SFR) recommendations on the everyday management of patients with spondyloarthritis, including psoriatic arthritis. Joint Bone Spine. 2022;89(3):105344. doi: 10.1016/j.jbspin.2022.105344Wendling D, Hecquet S, Fogel O, Letarouilly JG, Verhoeven F, Pham T, et al. 2022 French Society for Rheumatology (SFR) recommendations on the everyday management of patients with spondyloarthritis, including psoriatic arthritis. Joint Bone Spine. 2022;89(3):105344. doi: 10.1016/j.jbspin.2022.105344Machado P, Landewe R. Spondyloarthritis: Is it time to replace BASDAI with ASDAS? Nat Rev Rheumatol. 2013;9(7):388-390. doi: 10.1038/nrrheum.2013.93Machado P, Landewe R. Spondyloarthritis: Is it time to replace BASDAI with ASDAS? Nat Rev Rheumatol. 2013;9(7):388-390. doi: 10.1038/nrrheum.2013.93Pedersen SJ, Sørensen IJ, Garnero P, Johansen JS, Madsen OR, Tvede N, et al. ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNFα inhibitors. Ann Rheum Dis. 2011;70(8):1375-1381. doi: 10.1136/ard.2010.138883Pedersen SJ, Sørensen IJ, Garnero P, Johansen JS, Madsen OR, Tvede N, et al. ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNFα inhibitors. Ann Rheum Dis. 2011;70(8):1375-1381. doi: 10.1136/ard.2010.138883Cooksey R, Choy E. Exploring gender differences, medical history, and treatments used in patients with fibromyalgia in the UK using primary-care data: A retrospective, population-based, cohort study. Lancet Rheumatol. 2022;4:20. doi: 10.1016/S2665-9913(22)00296-XCooksey R, Choy E. Exploring gender differences, medical history, and treatments used in patients with fibromyalgia in the UK using primary-care data: A retrospective, population-based, cohort study. Lancet Rheumatol. 2022;4:20. doi: 10.1016/S2665-9913(22)00296-XWach J, Letroublon MC, Coury F, Tebib JG. Fibromyalgia in spondyloarthritis: Effect on disease activity assessment in clinical practice. J Rheumatol. 2016;43(11):2056-2063. doi: 10.3899/jrheum.160104Wach J, Letroublon MC, Coury F, Tebib JG. Fibromyalgia in spondyloarthritis: Effect on disease activity assessment in clinical practice. J Rheumatol. 2016;43(11):2056-2063. doi: 10.3899/jrheum.160104Lee S, Kang S, Kim H, Lee J, Kim MJ, Cha HS. Sex-specific disparities in disease activity scores among patients with axial spondyloarthritis and their implications for evaluating the response to tumor necrosis factor alpha inhibitor therapy. Arthritis Res Ther. 2024;26(1):90. doi: 10.1186/s13075-024-03320-xLee S, Kang S, Kim H, Lee J, Kim MJ, Cha HS. Sex-specific disparities in disease activity scores among patients with axial spondyloarthritis and their implications for evaluating the response to tumor necrosis factor alpha inhibitor therapy. Arthritis Res Ther. 2024;26(1):90. doi: 10.1186/s13075-024-03320-xRuau D, Liu LY, Clark JD, Angst MS, Butte AJ. Sex differences in reported pain across 11,000 patients captured in electronic medical records. J Pain. 2012;13(3):228-234. doi: 10.1016/j.jpain.2011.11.002Ruau D, Liu LY, Clark JD, Angst MS, Butte AJ. Sex differences in reported pain across 11,000 patients captured in electronic medical records. J Pain. 2012;13(3):228-234. doi: 10.1016/j.jpain.2011.11.002Корсакова ЮЛ, Коротаева ТВ, Логинова ЕЮ, Губарь ЕЕ, Петров АВ, Патрикеева ИМ, и др. Клинико-инструментальная характеристика псориатического артрита у мужчин и женщин. Данные когортного наблюдательного исследования. Терапевтический архив. 2024;96(5):479-485. doi: 10.26442/00403660.2024.05.202703Korsakova YuL, Korotaeva TV, Loginova EIu, Gubar EЕ, Petrov AV, Patrikeeva IM, et al. Clinical and instrumental characteristics of psoriatic arthritis in men and women. Data from a cohort observational study. Terapevticheskii arkhiv. 2024;96(5):479-485. (In Russ.). doi: 10.26442/00403660.2024.05.202703Blasco-Blasco M, Castrejon I, Jovani V, Pascual E, Ruiz-Cantero MT. Reviewing disease activity indices in spondyloarthritis from the sex perspective: A systematic review and metaanalysis. J Rheumatol. 2021;48(9):1395-1404. doi: 10.3899/jrheum.200967Blasco-Blasco M, Castrejon I, Jovani V, Pascual E, Ruiz-Cantero MT. Reviewing disease activity indices in spondyloarthritis from the sex perspective: A systematic review and metaanalysis. J Rheumatol. 2021;48(9):1395-1404. doi: 10.3899/jrheum.200967

The authors declare that there are no conflicts of interest present.