Understanding differences between men and women with axial spondyloarthritis.

Seminars in Arthritis and Rheumatism
Grace C WrightAtul A Deodhar

Abstract

Axial spondyloarthritis (axSpA) is a chronic inflammatory immune-mediated disease resulting in inflammatory low back pain and other inflammatory manifestations in peripheral joints and entheses. AxSpA encompasses both ankylosing spondylitis (AS), in which patients present with definitive sacroiliitis visible on radiographic imaging, as well as nonradiographic axSpA (nr-axSpA), in which such changes may not be discernable. Emerging evidence suggests that women and men experience axSpA differently. Although the prevalence of AS is approximately 2- to 3- fold higher in men than in women, nr-axSpA occurs with roughly equal frequency in women and men. The goal of this review is to increase awareness of sex differences in axSpA by exploring the distinct manifestations of disease and disease characteristics in women, the overall clinical burden, recommendations for diagnosis, and potential treatment options. We summarize and contextualize the results of recent studies that illuminate sex differences in nr-axSpA and AS, including differences in disease manifestation and progression. It is important that sex differences in axSpA are understood and considered when diagnosing and treating the spectrum of axSpA, including AS and nr-axSpA.

Citations

Apr 4, 2021·International Journal of Molecular Sciences·Katarzyna Romanowska-PróchnickaDariusz Szukiewicz
Jun 12, 2021·Scientific Reports·James T RosenbaumDongseok Choi
Jul 3, 2021·The Journal of Rheumatology·Ying Ying Leung
Oct 12, 2021·Frontiers in Medicine·Alen ZabottiEnnio Giulio Favalli

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