Ensslin, Caroline; Micheroli, Raphael; Kissling, Seraphina; Götschi, Andrea; Bürki, Kristina; Bräm, René; de Hooge, Manouk; Baraliakos, Xenofon; Nissen, Michael J; Möller, Burkhard; Exer, Pascale; Andor, Michael; Distler, Oliver; Scherer, Almut; Ciurea, Adrian (2023). Impact of sex on spinal radiographic progression in axial spondyloarthritis: a longitudinal Swiss cohort analysis over a period of 10 years. RMD open, 9(3) BMJ Publishing Group 10.1136/rmdopen-2023-003340
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OBJECTIVE
To investigate sex differences in spinal radiographic progression in axial spondyloarthritis (axSpA).
METHODS
AxSpA patients in the Swiss Clinical Quality Management cohort with available spinal radiographs every 2 years were included. Paired radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Progression was defined as an increase of ≥2 mSASSS units in 2 years. The relationship between sex and progression was investigated with binomial generalised estimating equation models, considering baseline spinal damage as an intermediate covariate. Additional analyses included adjustments for explanatory variables and multiple imputations for missingness.
RESULTS
In a total of 505 axSpA patients (317 men and 188 women), mean±SD radiographic progression over 2 years was 1.0±2.8 years in men and 0.3±1.1 years in women (p<0.001). Male sex was associated with enhanced progression in a small model not including baseline damage (OR 3.41, 95% CI 1.87 to 6.21). Both a direct effect of male sex on spinal progression, and an indirect effect, via enhancement of baseline spinal damage were significant (OR 2.06, 95% CI 1.15 to 3.67 and OR 1.04, 95% CI 1.01 to 1.07, respectively). A significant impact of male sex on spinal radiographic progression was still demonstrated after multiple adjustments for covariates known to potentially affect spinal radiographic progression (OR 1.97, 95% CI 1.04 to 3.71).
CONCLUSIONS
Spinal radiographic progression in axSpA is more severe in men than in women, with three times higher odds of progression in male patients and an effect that is mediated in part through an increase in baseline radiographic damage.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology |
UniBE Contributor: |
Möller, Burkhard |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2056-5933 |
Publisher: |
BMJ Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
02 Aug 2023 08:41 |
Last Modified: |
02 Aug 2023 08:49 |
Publisher DOI: |
10.1136/rmdopen-2023-003340 |
PubMed ID: |
37507208 |
Uncontrolled Keywords: |
epidemiology outcome assessment, health care spondylitis, ankylosing tumor necrosis factor inhibitors |
BORIS DOI: |
10.48350/185119 |
URI: |
https://boris.unibe.ch/id/eprint/185119 |
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