Clinical aspects
Clinical and epidemiological differences between men and women with systemic sclerosis: a study in a Spanish systemic sclerosis cohort and literature review
M. Freire1, A. Rivera2, B. Sopeña3, C. Tolosa Vilella4, A. Guillén Del Castillo5, D. Colunga Argüelles6, J.L. Callejas Rubio7, M. Rubio Rivas8, L. Trapiella Martínez9, J.A. Todolí Parra10, M. Rodríguez Carballeira11, N. Iniesta Arandia12, F.J. García Hernández13, M.V. Egurbide Arberas14, L. Sáez Comet15, J.A. Vargas Hitos16, J.J. Ríos Blanco17, A. Marín Ballvé18, X. Pla Salas19, A.B. Madroñero Vuelta20, M. Ruiz Muñoz21, V. Fonollosa Pla22, C.P. Simeón Aznar23
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain. maria.carmen.freire.dapena@sergas.es
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain.
- Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago, Spain.
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain.
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain.
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain.
- Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
- Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain.
- Department of Internal Medicine, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- Department of Internal Medicine, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain.
- Collagenosis and Pulmonary Hypertension Unit, Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
- Department of Internal Medicine, Hospital Universitario Cruces, Barakaldo, Spain.
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain.
- Department of Internal Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain.
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain.
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
- Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain.
- Department of Internal Medicine, Hospital General San Jorge, Huesca, Spain.
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcon, Madrid, Spain.
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain.
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain.
on behalf of RESCLE investigators, Autoimmune Diseases Study Group (GEAS)
CER10557
2017 Vol.35, N°4 ,Suppl.106
PI 0089, PF 0097
Clinical aspects
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PMID: 28980905 [PubMed]
Received: 05/05/2017
Accepted : 01/08/2017
In Press: 18/09/2017
Published: 12/10/2017
Abstract
OBJECTIVES:
The low overall prevalence of systemic sclerosis (SSc) and the low proportion of male patients have resulted in a scarcity of studies assessing sex differences in Ssc patients, and contradictory results have often been show among those studies that have been performed.
METHODS:
A prospective study was conducted with the Spanish RESCLE register to analyse the influence of gender on survival of SSc patients.
RESULTS:
In total, 1506 SSc patients (1341 women, 165 men) were recruited from 21 centres. Older age at onset (OR 1.02), shorter time from onset to diagnosis (OR 0.96), smoking (OR 2.57), interstitial lung disease (ILD) (OR 1.58), less predisposition to sicca syndrome and to antinuclear antibody positivity (OR 0.29 and 0.43, respectively), and higher compliance with the ACR 1980 criteria (OR 1.79) were independently associated with the male sex. During follow-up, 30.4% of men versus 14.6% of women died (p<0.001). Survival at 10 years from the onset of symptoms was 75.3% for men and 92.9% for women (p<0.001), and the difference remained after selecting only SSc-related deaths (85.6% vs. 96.1%, p<0.001). The mortality predictive factors were diffuse SSc (OR 2.26), ILD (OR 1.82), digital ulcers (OR 1.38), tendon friction rubs (OR 1.74), male sex (OR 1.53), increased age at onset (OR 1.13) and isolated PH (considering only deaths from diagnosis), both in the overall (OR 3.63) and female cohorts (OR 3.97). The same risk factors were observed in the male cohort, except for isolated PH and ILD.
CONCLUSIONS:
The present study confirms the existence of epidemiological, clinical, laboratory and prognostic gender differences in systemic sclerosis patients.
