While women with rheumatoid arthritis outnumber men, the results of a recent French study indicate that sex has little effect on the severity of the disease. Nonetheless, women more frequently undergo joint surgery.
In a study published in the Journal of Rheumatology, Dr. Laure Gossec, of Hopital Cochin, in Paris, and colleagues compared 133 male rheumatoid arthritis patients with 133 female patients with the same disease duration, about seven years.
The team collected data on demographic factors, patterns of joint involvement, range of symptoms, medical treatment and joint surgery. In addition, they obtained biological measures, genetic information, X-rays of the hands and feet, and heath assessment questionnaire results.
Women experienced sicca syndrome — dryness of the eyes and mouth — more frequently than men (35 percent versus 16 percent, respectively). The authors observed no other differences in other arthritis-related symptoms and health assessment questionnaire scores were comparable between men and women.
Men and women did not differ in terms of genetic profile distributions. At least one disease-associated gene was identified in 72.0 percent of men and 70.7 percent of women. However, 21 percent of women had two disease-associated genes, compared with 11 percent of men.
There were no other differences between the sexes in clinical, biological or radiological indicators.
Compared with men, women were prescribed significantly more disease-modifying antirheumatic drugs (DMARD). The average number of DMARD used was 3.3 and 2.8 for women and men, respectively. Overall, 43.6 percent of women received more than three DMARDs during follow-up, compared with 32.3 percent of men. Corticosteroid drug use did not differ between men and women.
Concerning surgery, there was no difference in the number of surgeries to remove the joint lining or for large-joint replacement, Gossec’s team reports. However, women underwent more fusion and replacement surgeries on smaller joints.
The investigators say the surgery findings are “interesting,” given the lack of difference between men and women on X-ray findings. Perhaps, they suggest, rheumatoid joint destruction is more disabling in women, leading to more surgery.
