Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort

Neuenschwander, Regula; Hebeisen, Monika; Micheroli, Raphael; Bürki, Kristina; Exer, Pascale; Niedermann, Karin; Nissen, Michael J.; Scherer, Almut; Ciurea, Adrian

doi:10.1186/s13075-020-02337-2

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-26027

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort
Authors:	Neuenschwander, Regula Hebeisen, Monika Micheroli, Raphael Bürki, Kristina Exer, Pascale Niedermann, Karin Nissen, Michael J. Scherer, Almut Ciurea, Adrian
et. al:	No
DOI:	10.1186/s13075-020-02337-2 10.21256/zhaw-26027
Published in:	Arthritis Research & Therapy
Volume(Issue):	22
Issue:	233
Issue Date:	2020
Publisher / Ed. Institution:	BioMed Central
ISSN:	1478-6362
Language:	English
Subjects:	Axial spondyloarthritis; Gender; Nonradiographic axial spondyloarthritis; TNF inhibition
Subject (DDC):	615.82: Physical therapy 616.7: Diseases of musculoskeletal system and orthopaedics
Abstract:	Background: Sex differences with regard to clinical manifestations and response to tumor necrosis factor inhibitors (TNFi) have been delineated for the radiographic form of axial spondyloarthritis (axSpA). More limited evidence for a differential effectiveness of treatment in genders exists for the nonradiographic disease state (nr-axSpA). The aim of the study was to compare demographics, clinical parameters, and response to TNFi in women versus men with nr-axSpA. Methods: We compared disease characteristics of 264 women and 231 men with nr-axSpA at inclusion in the prospective Swiss Clinical Quality Management Cohort. Response to a first TNFi was assessed in 85 women and 78 men without diagnosed co-morbid fibromyalgia. The primary outcome was the proportion of patients achieving the 40% improvement in the Assessment of SpondyloArthritis international Society criteria (ASAS40) at 1 year. Additional response outcomes were evaluated as secondary outcomes. Patients having discontinued TNFi were considered non-responders. Logistic regression analyses were adjusted for baseline differences, which might potentially mediate the effect of sex on treatment response. Results: Compared to men, women had a longer diagnostic delay, a higher level of perceived disease activity, and more enthesitis and were in a lower percentage HLA-B27 positive. An ASAS40 response was achieved by 17% of women and 38% of men (OR 0.34; 95% CI 0.12, 0.93; p = 0.02). A significantly lower response rate in women was confirmed in the adjusted analysis (OR 0.19; 95% CI 0.05, 0.62; p = 0.009) as well as for the other outcomes assessed. Conclusion: Despite only few sex differences in patient characteristics in nr-axSpA, response rates to TNFi are significantly lower in women than in men.
URI:	https://digitalcollection.zhaw.ch/handle/11475/26027
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Neuenschwander, R., Hebeisen, M., Micheroli, R., Bürki, K., Exer, P., Niedermann, K., Nissen, M. J., Scherer, A., & Ciurea, A. (2020). Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort. Arthritis Research & Therapy, 22(233). https://doi.org/10.1186/s13075-020-02337-2

Neuenschwander, R. et al. (2020) ‘Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort’, Arthritis Research & Therapy, 22(233). Available at: https://doi.org/10.1186/s13075-020-02337-2.

R. Neuenschwander et al., “Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort,” Arthritis Research & Therapy, vol. 22, no. 233, 2020, doi: 10.1186/s13075-020-02337-2.

NEUENSCHWANDER, Regula, Monika HEBEISEN, Raphael MICHEROLI, Kristina BÜRKI, Pascale EXER, Karin NIEDERMANN, Michael J. NISSEN, Almut SCHERER und Adrian CIUREA, 2020. Differences between men and women with nonradiographic axial spondyloarthritis : clinical characteristics and treatment effectiveness in a real-life prospective cohort. Arthritis Research & Therapy. 2020. Bd. 22, Nr. 233. DOI 10.1186/s13075-020-02337-2

Neuenschwander, Regula, Monika Hebeisen, Raphael Micheroli, Kristina Bürki, Pascale Exer, Karin Niedermann, Michael J. Nissen, Almut Scherer, and Adrian Ciurea. 2020. “Differences between Men and Women with Nonradiographic Axial Spondyloarthritis : Clinical Characteristics and Treatment Effectiveness in a Real-Life Prospective Cohort.” Arthritis Research & Therapy 22 (233). https://doi.org/10.1186/s13075-020-02337-2.

Neuenschwander, Regula, et al. “Differences between Men and Women with Nonradiographic Axial Spondyloarthritis : Clinical Characteristics and Treatment Effectiveness in a Real-Life Prospective Cohort.” Arthritis Research & Therapy, vol. 22, no. 233, 2020, https://doi.org/10.1186/s13075-020-02337-2.