ABSTRACT
Objective:
To compare gender related clinical and laboratory characteristics and disease related outcomes of patients with axial spondyloarthritis (axSpA) treated with tumour necrosis factor inhibitors (TNF-i).
Methods:
Two-hundred and eighty-three axSpA patients (84 females) who received TNF-i due to resistant disease activity were included in this cross-sectional analysis. Females were compared to males in terms of clinical and laboratory characteristics of the disease in all cohort and disease related outcomes Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) ve Ankylosing Spondylitis quality of life (ASQoL)] after TNF-i in 207 patients out of all cohort.
Results:
When compared to males, females were found to have less finger-to-floor distance and C-reactive protein levels (p<0.001), more frequently resistant peripheral arthritis and uveitis, and less acute phase response before the initiation of TNF-i (p=0.014 and p=0.044 and p=0.046, respectively). One fourth of both of two gender required to switch to second or third TNF-i agents due to inefficacy or adverse events. After a mean duration of 37 months of TNF-i, BASMI and BASFI levels were similar, BASDAI and AsQoL scores were found to be higher in females (p<0.001).
Conclusion:
In this study, including predominantly radiographic axSpA patients who received TNF-i due to resistant disease activity, females had more frequent active peripheral arthritis and uveitis and less acute phase response before TNF-i. After the initiation of TNF-i, despite similar spinal mobility and functional status with males, females were shown to have higher disease activity and poor quality of life.
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