Clinical aspects
Gender differences in early systemic sclerosis patients: a report from the EULAR scleroderma trials and research group (EUSTAR) database
P.E. Carreira1, L. Carmona2, B.E. Joven3, E. Loza4, J.L. Andreu5, G. Riemekasten6, S. Vettori7, A. Balbir-Gurman8, P. Airò9, U.A. Walker10, N. Damjanov11, M. Matucci-Cerinic12, L.P. Ananieva13, S. Rednic14, L. Czirják15, O. Distler16, D. Farge17, R. Hesselstrand18, A. Corrado19, P. Caramaschi20, M. Tikly21, Y. Allanore22
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain. carreira@h12o.es
- Instituto de Salud Musculoesquelética, Madrid, Spain.
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.
- Instituto de Salud Musculoesquelética, Madrid, Spain.
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, Spain.
- Department of Rheumatology, University of Lübeck, Germany.
- U.O.C. di Reumatologia, Dipartimento di Internistica Clinica e Sperimentale “F.Magrassi-A-Lanzara”, Seconda Università degli Studi di Napoli, Italy.
- B. Shine Rheumatology Unit, Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion, Haifa, Israel.
- U.O. Reumatologia e Immunologia Clinica. Spedali Civili, Brescia, Italy.
- Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland.
- University of Belgrade School of Medicine, Institute of Rheumatology Belgrade, Serbia.
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Italy.
- Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia.
- Clinica Reumatologie, University of Medicine & Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania.
- Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Hungary.
- Department of Rheumatology, University Hospital Zürich, Switzerland.
- Department of Internal Medicine, Hopital Saint-Louis, Paris, France.
- Department of Rheumatology, Lund University Hospital, Sweden.
- U.O. Reumatologia-Università degli Studi di Foggia, Ospedale 'Col. D'Avanzo', Foggia, Italy.
- Rheumatology Unit, AOUI, Verona, Italy.
- Rheumatology Unit, Department of Medicine Chris Hani Bardgwanath, Hospital and University of the Witwatersrand, Johannesburg, South Africa.
- Rheumatology A Department, Cochin Hospital, APHP, Paris Descartes University, Paris, France.
and the EUSTAR co-authors
CER10523
2018 Vol.36, N°4 ,Suppl.113
PI 0068, PF 0075
Clinical aspects
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PMID: 30277860 [PubMed]
Received: 21/04/2017
Accepted : 09/03/2018
In Press: 29/09/2018
Published: 29/09/2018
Abstract
OBJECTIVES:
To describe differences in clinical presentation between men and women in a large group of patients with early (<3 years’ duration) systemic sclerosis (SSc) according to disease subsets.
METHODS:
A cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research database (EUSTAR) was performed. Patients fulfilling preliminary ACR 1980 classification criteria for SSc, with less than 3 years from the first non-Raynaud’s symptom at first entry, were selected. A group of patients with less than 3 years from the first SSc symptom, including Raynaud’s phenomenon, was also analysed. SSc related variables, including antibodies, SSc subsets, disease activity and organ involvement were included. Descriptive and bivariate analyses were performed.
RESULTS:
A total of 1,027 patients were included, 90% Caucasian, 80% women, and 40% with diffuse cutaneous disease. In early stages of SSc, men showed more frequently than women active disease, diffuse cutaneous subset, anti-Scl-70 antibodies, elevated acute phase reactants, muscular and pulmonary involvement. Differences between men and women were confirmed in the limited, but not in the diffuse SSc subset. The results were similar when 650 patients with less than three years from the first SSc symptom, including Raynaud’s phenomenon, were analysed.
CONCLUSIONS:
In early stages of SSc, men present signs and symptoms of more severe disease. In the limited disease subset, men might appear with clinical features and organ involvement similar to those of the diffuse subgroup. In clinical practice, the identification of such differences might help to select the appropriate management for each particular patient.
