Artritis reumatoide: ¿enfermedad de género?

La artritis reumatoide es una condición que causa dolor crónico en las articulaciones, especialmente prevalente en las mujeres que en los varones y con mayor agresividad en el género femenino. Un estudio llevado a cabo en 25 países confirma que los síntomas son peores en las mujeres y la incidencia tiene predilección (79% eran mujeres).

Los casos estudiados completaron un formulario sobre la enfermedad. La investigación coordinada por Tuulikki Sokka, del Hospital Central Jyvaskyla Central Hospital en Finlandia, parece indicar que la artritis guarda relación con las características/diferencias del sistema musculoesquelético masculino y femenino. En los casos que el sistema musculoesquelético es similar al masculino, el riesgo de artritis se reduce.

 Sokka T, et al; the QUEST-RA Group. Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA Study. Arthritis Res Ther 2009 Jan 14;11(1):R7.

Jyväskylä Central Hospital,  Hämeentie 1, 44100 Aänekoski, Finland.

ABSTRACT: Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). METHODS: The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. RESULTS: Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P < 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P < 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance was marginal. Similar proportions of females and males were taking different therapies. CONCLUSIONS: In this large multinational cohort, RA disease activity measures appear to be worse in women than in men. However, most of the gender differences in RA disease activity may originate from the measures of disease activity rather than from RA disease activity itself.

servido por gineblog 3 comentarios compártelo