Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study

Casper Webers, I. Essers, S. Ramiro, C. Stolwijk, R. Landewé, D. van der Heijde, F. van den Bosch, M. Dougados, A. van Tubergen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives. To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time.

Methods. Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations.

Results. A total of 216 patients [154 (72.3%) males, mean age 43.6 years (S.D. 12.7), symptom duration 20.5 years (s.o. 11.8), mean follow-up duration 8.3 years (S.D. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P=0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P=0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P=0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P <0.01).

Conclusion. In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time.

Original languageEnglish
Pages (from-to)419-428
Number of pages10
JournalRheumatology
Volume55
Issue number3
Early online date9 Nov 2015
DOIs
Publication statusPublished - Mar 2016

Keywords

  • ankylosing spondylitis
  • sex
  • gender
  • epidemiology
  • longitudinal studies
  • QUALITY-OF-LIFE
  • HEALTH SURVEY SF-36
  • DISEASE-ACTIVITY
  • AXIAL SPONDYLOARTHRITIS
  • RADIOGRAPHIC PROGRESSION
  • COHORT
  • INDEX
  • BATH
  • SPONDYLARTHRITIS
  • SYNDESMOPHYTES

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