RT Journal Article
SR Electronic
T1 Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients
JF RMD Open
JO RMD Open
FD EULAR
SP e001681
DO 10.1136/rmdopen-2021-001681
VO 7
IS 3
A1 Maria-Sole Chimenti
A1 Rieke Alten
A1 Maria-Antonieta D'Agostino
A1 Elisa Gremese
A1 Uta Kiltz
A1 Ennio Lubrano
A1 Mireia Moreno
A1 Thao Pham
A1 Roberta Ramonda
A1 Francesca-Romana Spinelli
A1 Chiara Perella
A1 Laura Andreoli
YR 2021
UL http://rmdopen.bmj.com/content/7/3/e001681.abstract
AB Emerging evidence suggests that axial spondyloarthritis (axSpA) should not be seen as a predominantly male disease, as the non-radiographic form occurs with roughly equal frequency in women and men. However, men and women experience this disease differently. The purpose of this review is to highlight sex-associated and gender-associated differences in the patient’s journey through the diagnosis and management of axSpA, in order to increase the awareness about the unmet needs of female axSpA patients.Female patients experience a longer diagnostic delay compared with men, possibly due to the different pattern of clinical presentations across genders. Therefore, it is crucial to sensitise physicians to pay attention and identify the red flags of axSpA in women and promote early referral to a rheumatologist. Women with a diagnosis of axSpA experience greater limitations in physical function, although they have less structural spinal damage compared with men. Women tend to have less adherence and a lower response to treatment, so more gender-oriented data are needed about drugs used for axSpA, especially biological disease-modifying antirheumatic drugs.Lifestyle factors have a strong impact on the disease course. Interventions regarding physical activity, smoking cessation and diet should be communicated to the patients, with particular attention to the gender-related cultural background.Patients of childbearing age living with axSpA should be engaged in a discussion about reproductive health, in terms of preservation of fertility, management of pregnancy and delivery and use of biologic drugs during pregnancy and breastfeeding.