J Rheum Dis.  2012 Jun;19(3):132-137. 10.4078/jrd.2012.19.3.132.

Gender Differences in Clinical Features and Anti-TNF Agent Use in Korean Ankylosing Spondylitis Patients

Affiliations
  • 1Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea.
  • 2Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 3Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. rapark@catholic.ac.kr
  • 4Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Abstract


OBJECTIVE
The aim of this study was to assess the gender differences in the clinical presentation and treatment patterns between Korean women and men with ankylosing spondylitis (AS).
METHODS
We retrospectively analyzed the data from extensive clinical assessments of 721 patients (162 women and 559 men) with AS, who were diagnosed at Seoul St. Mary's Hospital, between January 2000 and September 2009. Clinical data, regarding the disease onset, disease duration, clinical presentations, status of human leukocyte antigen (HLA)-B27, and bone mineral density, were determined using a dual-energy X-ray absorptiometry (DEXA). Finally, we analyzed the medical treatments prescribed for these patients.
RESULTS
The ratio of men to women was 3.45:1. Compared to men, women were older at the time of diagnosis, had shorter disease durations, and were diagnosed in earlier stages of the disease. More women had a history of uveitis at diagnosis than men. Back pain was the main presenting symptom, and its prevalence was the same in both genders. Fewer women showed cervical and thoracic axial involvement than men. Initially, more women had wrist and hand pain than men; however, at some point, peripheral arthritis development was equally likely in both genders. Women experienced shoulder pain, during the disease course, more often thanmen. On the other hand, men presented with knee and hip pain more often than women. Sulfasalazine and anti-TNF agents were more often prescribed to women.
CONCLUSION
The presentation and progression of AS showed a difference between women and men. Because of these differences, AS should be considered when a women presents with peripheral arthritis or uveitis in the early stage of the disease.

Keyword

Differences; Clinical presentation; Women; Ankylosing spondylitis; Men

MeSH Terms

Absorptiometry, Photon
Arthritis
Back Pain
Bone Density
Female
Hand
Hip
Humans
Knee
Leukocytes
Male
Prevalence
Retrospective Studies
Shoulder Pain
Spondylitis, Ankylosing
Sulfasalazine
Uveitis
Wrist
Sulfasalazine

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