Sex-associated Treatment Differences and Their Outcomes in Rheumatoid Arthritis: Results from the METEOR Register
Sytske Anne Bergstra,Cornelia F Allaart,Sofia Ramiro,Arvind Chopra,Nimmisha Govind,Cândida Silva,Elizabeth Murphy,Robert B.M. Landewé,Robert B.M. Landewé +8 more
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TLDR
This worldwide observational study suggests that in daily practice, men and women with RA are prescribed different initial treatments, but there were no differences in response to treatment between the sexes.Abstract:
Objective. To assess differences in initial treatment and treatment response in male and female patients with rheumatoid arthritis (RA) in daily clinical practice. Methods. The proportion of patients with RA starting different antirheumatic treatments (disease-modifying antirheumatic drugs; DMARD) and the response to treatment were compared in the international, observational METEOR register. All visits from start of the first DMARD until the first DMARD switch or the end of followup were selected. The effect of sex on time to switch from first to second treatment was calculated using Cox regression. Linear mixed model analyses were performed to assess whether men and women responded differently to treatments, as measured by Disease Activity Score (DAS) or Health Assessment Questionnaire. Results. Women (n = 4393) more often started treatment with hydroxychloroquine, as monotherapy or in combination with methotrexate (MTX) or a glucocorticoid, and men (n = 1142) more often started treatment with MTX and/or sulfasalazine. Time to switch DMARD was shorter for women than for men. Women had a statistically significantly higher DAS over time than men (DAS improvement per year β −0.69, 95% CI −0.75 to −0.62 for men and −0.58, 95% CI −0.62 to −0.55 for women). Subanalyses per DMARD group showed for the conventional synthetic DMARD combination therapy a slightly greater decrease in DAS over time in men (−0.89, 95% CI −1.07 to −0.71) compared to women (−0.59, 95% CI −0.67 to −0.51), but these difference between the sexes were clinically negligible. Conclusion. This worldwide observational study suggests that in daily practice, men and women with RA are prescribed different initial treatments, but there were no differences in response to treatment between the sexes.read more
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Molecular Mechanisms of Sex-Related Differences in Arthritis and Associated Pain
Ju-Ryoung Kim,Hyun Ah Kim +1 more
TL;DR: Current advances in both clinical and preclinical research regarding sex-related differences in the development or severity of arthritis and associated pain are discussed.
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Sex and autoimmunity: proposed mechanisms of disease onset and severity.
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TL;DR: The present review will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in Rheumatic patients.
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TL;DR: Evaluating how sex and gender can impact current management guidelines and how this issue can be integrated for effective disease control is evaluated.
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The impact of gender on time to rheumatoid arthritis classification: a retrospective analysis of a population-based cohort.
TL;DR: There was no significant delay in meeting 1987 and2010 ACR/EULAR classification criteria between female and male RA patients, though time to meeting both 1987 and 2010 criteria was slightly longer in males compared with females.
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Impact of Sex on Clinical Response in Rheumatoid Arthritis Patients Treated With Biologics at Approved Dosing Regimens.
Lanyan Fang,Xuyang Song,Ping Ji,Yaning Wang,Janet Maynard,Sarah Yim,Chandrahas G. Sahajwalla,Mingjiang Xu,Myong-Jin Kim,Liang Zhao +9 more
TL;DR: The meta‐analysis did not find significant difference in ACR20 response rates between male and female RA patients treated with biologics at approved dosing regimens, which supports the current clinical practice of not requiring sex‐dependent treatment regimens for RA patients.
References
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Book
Analysis of Incomplete Multivariate Data
TL;DR: The Normal Model Methods for Categorical Data Loglinear Models Methods for Mixed Data and Inference by Data Augmentation Methods for Normal Data provide insights into the construction of categorical and mixed data models.
Journal ArticleDOI
Measurement of patient outcome in arthritis.
TL;DR: A structure for representation of patient outcome is presented, together with a method for outcome measurement and validation of the technique in rheumatoid arthritis, and these techniques appear extremely useful for evaluation of long term outcome of patients with rheumatic diseases.
Journal ArticleDOI
Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score.
D. van der Heijde,M.A. van 't Hof,P.L.C.M. van Riel,L A Theunisse,Erik Lubberts,M.A. van Leeuwen,M. H. Van Rijswijk,L. B. A. Van De Putte +7 more
TL;DR: An investigation of clinical and laboratory variables which might form the basis for judging disease activity in clinical practice was made by six rheumatologists in a prospective study of up to three years' duration of 113 patients with early r heumatoid arthritis.
Journal ArticleDOI
Predictors of response to anti-TNF-alpha therapy among patients with rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register.
TL;DR: Data support an improved outcome among patients receiving MTX in combination with anti-TNF-alpha therapies, and the most disabled patients were less likely to respond, despite concurrent MTX, as well as the association of smoking and poor outcome with INF.
Journal ArticleDOI
Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics and treatments in the QUEST-RA study
Tuulikki Sokka,Sergio Toloza,Maurizio Cutolo,Hannu Kautiainen,Heidi Mäkinen,Feride Gogus,Vlado Skakic,Humeira Badsha,Tõnu Peets,Asta Baranauskaite,Pál Géher,Ilona Ujfalussy,Fotini N. Skopouli,Maria Mavrommati,Rieke Alten,Christof Pohl,Jean Sibilia,Andrea Stancati,Fausto Salaffi,Wojciech Romanowski,Danuta Zarowny-Wierzbinska,Dan Henrohn,Barry Bresnihan,Patricia Minnock,Lene Surland Knudsen,Johannes W G Jacobs,Jaime Calvo-Alén,Juris Lazovskis,Geraldo da Rocha Castelar Pinheiro,Dmitry Karateev,Daina Andersone,Sylejman Rexhepi,Yusuf Yazici,Theodore Pincus +33 more
TL;DR: In this large multinational cohort of patients with RA, RA disease activity measures appear to be worse in women than in men, however, most of the gender differences in RA diseaseactivity may originate from the measures of disease activity rather than from RA diseaseActivity itself.