COMPARATIVE ANALYSIS OF MAIN CLINICAL MANIFESTATIONS IN MALES AND FEMALES WITH EARLY AXIAL SPONDYLOARTHRITIS

Currently, there have been a small number of works on differences between males and females with axial spondyloarthritis (axSpA) and there have been no studies estimating a gender difference in radiographic sacroiliitis progression in axSpA.
Objective: to compare the main clinical manifestations of sacroiliitis and its radiological progression in axSpA in men and women over time during a 2-year follow-up period.
Subjects and methods. The investigation was conducted using the Moscow cohort from the early SpondyloArthritis (CoRSAr) study, which currently consisted of 175 patients. The analysis included 68 patients followed up for ≥2 years. Their mean age at the time of inclusion in the cohort was 28.5±5.8 years; the mean disease duration was 24.1±15.4 months. 92.6% of patients were HLA-B27-positive.
Results and discussion. Among the 68 patients followed up over 2 years, there were 33 (48.5%) men and 35 (51.5%) women. At baseline, the females were older than the males (p<0.01), while the disease duration was the same and averaged about 2 years. Among the males, there were more patients with ankylosing spondylitis (AS) than those among the females (75.5 and 42.8%, respectively; p<0.05), and the men had a higher total score of radiological sacroiliitis (tsrSI) than the women. The level of C-reactive protein (CRP) was also higher in the men than in the women (12.8 and 4.3 mg/l, respectively; p<0.05). Two years later, AS was present in 90.9% of the males and in 60.0% of the females (p<0.05).
Conclusion. Women fall ill with axSpA later than men, and the latter are more frequently observed to have HLA-B27, higher tsrSI and elevated CRP levels. Progression from non-radiological axSpa to AS was more common in men.

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68. Sieper J, Rudwaleit M, Baraliakos X, 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.2008.104018

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73. Smirnov AV, Erdes ShF. Optimization of X-ray diagnosis of ankylosing spondylitis in clinical practice: Importance of a plain X-ray film of the pelvis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2015;53(2):175-81 (In Russ.). doi: 10.14412/1995-4484-2015-175-181

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75. Dubinina TV, Gaidukova IZ, Godzenko AA, et al. Guidelines for the assessment of disease activity and functional status in patients with ankylosing spondylitis in clinical practice. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2017;55(4):344-50 (In Russ.). doi: 10.14412/1995-4484-2017-344-350

76. Protopopov M, Sieper J, Haibel H, et al. Relevance of structural damage in the sacroiliac joints for the functional status and spinal mobility in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Res Ther. 2017;19(1):240. doi: 10.1186/s13075-017-1453-3

77. Dougados M, Sepriano A, Molto A, et al. Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort. Ann Rheum Dis. 2017;76(11):1823-8. doi: 10.1136/annrheumdis-2017-211596

78. Smirnov AV, Erdes ShF. Optimization of X-ray diagnosis of ankylosing spondylitis in clinical practice: Importance of a plain X-ray film of the pelvis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2015;53(2):175-81 (In Russ.). doi: 10.14412/1995-4484-2015-175-181

79. Poddubnyy D, Haibel H, Listing J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012;64(5):1388-98. doi: 10.1002/art.33465

80. Protopopov M, Sieper J, Haibel H, et al. Relevance of structural damage in the sacroiliac joints for the functional status and spinal mobility in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Res Ther. 2017;19(1):240. doi: 10.1186/s13075-017-1453-3

81. Dougados M, Sepriano A, Molto A, et al. Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort. Ann Rheum Dis. 2017;76(11):1823-8. doi: 10.1136/annrheumdis-2017-211596

82. Poddubnyy D, Haibel H, Listing J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012;64(5):1388-98. doi: 10.1002/art.33465

83. Protopopov M, Sieper J, Haibel H, et al. Relevance of structural damage in the sacroiliac joints for the functional status and spinal mobility in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Res Ther. 2017;19(1):240. doi: 10.1186/s13075-017-1453-3

84. Poddubnyy D, Haibel H, Listing J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012;64(5):1388-98. doi: 10.1002/art.33465