Gender differences in organ involvement and survival in systemic sclerosis – experience of a EUSTAR center

Autor: Laura Groseanu, Andreea Petre, Andra Balanescu, Violeta Bojinca, Daniela Opris-Belinski, Florian Berghea, Ioana Saulescu, Diana Mazilu, Sanziana Daia Iliescu, Andreea Borangiu, Cosmin Constantinescu, Claudia Cobilinschi, Maria Magdalena Negru, Mihai Abobului, Ruxandra Ionescu
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Romanian Journal of Rheumatology, Vol 30, Iss 2, Pp 68-76 (2021)
ISSN: 2069-6086
1843-0791
Popis: Introduction. 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 observed. Material and method. We performed a retrospective observational study using data extract from the EULAR scleroderma trials and research (EUSTAR) cohort 096 . We looked at sex influence on disease characteristics at baseline and then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival. Results. 173 patients with SSc were available for the baseline analyses. In the longitudinal analysis after a mean follow-up of 3.5(±0.65) years, male sex was associated with a higher risk of scleroderma renal crisis (OR:9.45 (1.49 to 59.69); p = 0.004), digital contractures (OR:8.2 (3.1 to 21.9); p < 0.001), arrhythmias (OR: 3.37 (1.36 to 8.34); p = 0.006), pulmonary fibrosis (OR: 3.56, (1.51 to 8.41); p = 0.003), pulmonary hypertension (OR: 3.01 (1.19 to 7.59); p = 0.016), severe vascular involvement (OR:2.86, (1.22 to 6.73); p = 0.013) and low ventricular ejection fraction (OR: 2.84, (1.2 to 6.73); p = 0.014). Males had significantly reduced survival time after diagnosis (p = 0.004). The most frequent causes of death were scleroderma renal crisis in males and pulmonary hypertension in females. Conclusions. Although more common in women, SSc appears as strikingly more severe in men. Our results demonstrate a higher risk of severe organ involvement and poor prognosis in men. These results raise the point of including sex in the management and the decision-making process.
Databáze: OpenAIRE