Impact of sex on spinal radiographic progression in axial spondyloarthritis: a longitudinal Swiss cohort analysis over a period of 10 years.

Autor:	Ensslin C; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Micheroli R; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Kissling S; Statistics Group, Swiss Clinical Quality Management in Rheumatic Diseases, Zurich, Switzerland., Götschi A; Statistics Group, Swiss Clinical Quality Management in Rheumatic Diseases, Zurich, Switzerland., Bürki K; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Bräm R; Swiss Ankylosing Spondylitis Association, Zurich, Switzerland., de Hooge M; Department of Rheumatology, University Hospital Gent, Gent, Belgium., Baraliakos X; Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany., Nissen MJ; Department of Rheumatology, Geneva University Hospitals, Geneve, Switzerland., Möller B; Department of Rheumatology and Immunology, Inselspital Universitatsspital Bern, Bern, Switzerland., Exer P; Praxis Rheuma-Basel, Basel, Switzerland., Andor M; Rheumatology Practice Uster, Uster, Switzerland., Distler O; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Scherer A; Statistics Group, Swiss Clinical Quality Management in Rheumatic Diseases, Zurich, Switzerland., Ciurea A; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland adrian.ciurea@usz.ch.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2023 Jul; Vol. 9 (3).
DOI:	10.1136/rmdopen-2023-003340
Abstrakt:	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. Competing Interests: Competing interests: The SCQM foundation is supported by the Swiss Society of Rheumatology and by Abbvie, Astra Zeneca, Eli Lilly, iQone Healthcare, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Samsung Bioepis, and Sandoz. AC received honoraria for lectures from AbbVie, and Novartis. AS received consulting fees from Pfizer and support for attending meetings from Gilead. BM received speaking fees from Jansen, Novartis and Pfizer, support for attending meetings from Janssen and Pfizer, and a research grant from Celgene. MdH received grants from FWRO/FRSR and honoraria from UCB for participation in an advisory board. MJN received consulting and/or speaking fees from Abbvie, Amgen, Eli Lilly, Janssen, Novartis and Pfizer and a research grant from Novartis. He also received support from attending meetings from Janssen and UCB and participated in advisory boards for Eli Lilly, Janssen, Novartis and Pfizer. PE received financial support from UCB for attending a meeting. RM received honoraria for lectures or presentations from Abbvie, Eli Lilly, Janssen, Gilead and Pfizer. XB received consulting fees from Abbvie, BMS, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, Sanofi, and UCB. He received payment or honoraria for lectures or presentations from Abbvie, BMS, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, Sanofi, and UCB. He participated on advisory boards for Abbvie, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer and UCB. He is president of the Assessment of Spondyloarthritis international Society (ASAS) and EULAR president-elect. AG, CE, KB, MA, OD, RB and SK declare they have no conflicts of interest. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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