Tuesday, 18 Dec 2018

You are here

Does Gender Make a Difference in Axial Spondyloarthritis

Males and females can both be affected by axial spondyloarthritis (axSpA). A recent study shows that while there are some differences and similarities, HLA-B27 and imaging are still pivotal elements for diagnosis of axSpA in both genders.

The SPACE (SPondyloArthritis Caught Early) cohort was devised to assess adults with chronic back pain (CBP; duration ≥ 3 months and ≤ 2 years, age of onset < 45 years) and is the dataset for these analyses. 

From a total of 719 CBP patients, 275 were male and 444 were female. The subsequent diagnosis of axSpA was made in 53% of males and 35% of females. Thus males were more likely to be diagnosed with axSpA (OR 2.1, 95% CI 1.5–2.9).

Males differed from female axSpA patient by being younger at diagnosis (27.4  vs 29.5 years; p = 0.02), haveing more HLA-B27 positivity (80% vs 60%; p < 0.01) and more imaging positivity (MRI or radiograph sacroiliitis) (78% vs 64%; p = 0.01).

Women with SpA features did have the same symptom duration and were also HLA-B27+ (23%) and had  positive imaging studies 7% of the time.

In multivariate analyses, the diagnosis of axSpA was equally linked to HLA-B27 and imaging positivity in both sexes. Yet males and those who were HLA-B27+ were more likely to manifest imaging positivity.

These results do not endorse the need for separate diagnostic strategies for men and women with CBP.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Psoriatic Arthritis Does Not Add to Pregnancy Problems

When psoriatic arthritis (PsA) patients become pregnant, they do not have more infertility or adverse pregnancy outcomes compared to healthy controls.

This study is relevant as the average onset age of PsA ranges between the 4th-6th decades of life and therefore includes a period of child-bearing potential.

IL-23 Outduels IL-17 Inhibition in Psoriasis

Johnson & Johnson has announced the preliminary results of its phase 3 ECLIPSE study; a head-to-head trial wherein guselkumab (Tremfya; an IL-23 inhibitor) was compared to secukinumab (Cosentyx; an IL-17 inhibitor) in adults with moderate to severe plaque psoriasis.

New ACR/NPF Guidelines for Management of Psoriatic Arthritis

The American College of Rheumatology (ACR) and National Psoriasis Foundation (NPF) have released a joint treatment guideline for psoriatic arthritis (PsA) that provides evidence-based pharmacologic and non-pharmacologic recommendations and includes recommendations on other management issues including vaccinations, psoriatic spondylitis, enthesitis, and treatment in the presence of inflammatory bowel disease, diabetes, or serious infections.

Filgotinib in Psoriatic Arthritis and Ankylosing Spondylitis

Another, new Janus kinase 1 (JAK1) inhibitor is out with impressive data - this time its filgotinib, demonstrating its efficacy and safety two separate clinical trials of patients with psoriatic arthritis or ankylosing spondylitis.

Ixekizumab COAST-V Trial Wins in Axial Spondyloarthritis

Lancet has published the results of a study showing that ixekizumab (an IL-17A inhibitor) yielded significant clinical benefit and radiographic protection when given to NSAID treated patients with radiographic axial spondyloarthritis (AxSpA).