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Gender-attributable differences in outcome of ankylosing spondylitis : long-term results from the Outcome in Ankylosing Spondylitis International Study

(2016) RHEUMATOLOGY. 55(3). p.419-428
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Abstract
Objectives. To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time. Methods. Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations. Results. A total of 216 patients [154 (72.3%) males, mean age 43.6 years (S.D. 12.7), symptom duration 20.5 years (s.o. 11.8), mean follow-up duration 8.3 years (S.D. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P=0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P=0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P=0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P < 0.01). Conclusion. In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time.
Keywords
sex, ankylosing spondylitis, gender, epidemiology, longitudinal studies, QUALITY-OF-LIFE, HEALTH SURVEY SF-36, DISEASE-ACTIVITY, AXIAL SPONDYLOARTHRITIS, RADIOGRAPHIC PROGRESSION, COHORT, INDEX, BATH, SPONDYLARTHRITIS, SYNDESMOPHYTES

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MLA
Webers, Casper, Ivette Essers, Sofia Ramiro, et al. “Gender-attributable Differences in Outcome of Ankylosing Spondylitis : Long-term Results from the Outcome in Ankylosing Spondylitis International Study.” RHEUMATOLOGY 55.3 (2016): 419–428. Print.
APA
Webers, C., Essers, I., Ramiro, S., Stolwijk, C., Landewé, R., van der Heijde, D., Van den Bosch, F., et al. (2016). Gender-attributable differences in outcome of ankylosing spondylitis : long-term results from the Outcome in Ankylosing Spondylitis International Study. RHEUMATOLOGY, 55(3), 419–428.
Chicago author-date
Webers, Casper, Ivette Essers, Sofia Ramiro, Carmen Stolwijk, Robert Landewé, Désirée van der Heijde, Filip Van den Bosch, Maxime Dougados, and Astrid van Tubergen. 2016. “Gender-attributable Differences in Outcome of Ankylosing Spondylitis : Long-term Results from the Outcome in Ankylosing Spondylitis International Study.” Rheumatology 55 (3): 419–428.
Chicago author-date (all authors)
Webers, Casper, Ivette Essers, Sofia Ramiro, Carmen Stolwijk, Robert Landewé, Désirée van der Heijde, Filip Van den Bosch, Maxime Dougados, and Astrid van Tubergen. 2016. “Gender-attributable Differences in Outcome of Ankylosing Spondylitis : Long-term Results from the Outcome in Ankylosing Spondylitis International Study.” Rheumatology 55 (3): 419–428.
Vancouver
1.
Webers C, Essers I, Ramiro S, Stolwijk C, Landewé R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis : long-term results from the Outcome in Ankylosing Spondylitis International Study. RHEUMATOLOGY. 2016;55(3):419–28.
IEEE
[1]
C. Webers et al., “Gender-attributable differences in outcome of ankylosing spondylitis : long-term results from the Outcome in Ankylosing Spondylitis International Study,” RHEUMATOLOGY, vol. 55, no. 3, pp. 419–428, 2016.
@article{7220883,
  abstract     = {Objectives. To investigate gender-attributable differences regarding clinical outcome [disease activity, physical function and quality of life (QoL)] and radiographic damage in patients with AS over time. 
Methods. Data from the Outcome in AS International Study were used. Disease activity was assessed by the BASDAI, ASDAS and CRP; physical function by BASFI; QoL by the Short Form-36, Ankylosing Spondylitis Quality of Life (ASQoL) score and European Quality Of Life scale; and radiographic damage by the modified Stoke AS Spine Score (mSASSS). Cross-sectional comparative analyses were done at baseline. Next, separate models were created to assess gender-attributable differences on each outcome measure over time using time-adjusted generalized estimating equations. 
Results. A total of 216 patients [154 (72.3%) males, mean age 43.6 years (S.D. 12.7), symptom duration 20.5 years (s.o. 11.8), mean follow-up duration 8.3 years (S.D. 4.1)] were included. At baseline, male compared with female patients had lower self-reported disease activity (BASDAI 3.2 vs 3.9, P=0.03) but more radiographic damage (mSASSS 13.8 vs 6.5, P=0.02). No significant gender-attributable differences in other clinical parameters were found. In multivariable analysis, male gender was significantly associated with a better ASQoL (B = -1.18, 95% CI: -2.17, -0.20, P=0.02), and in a separate model with a higher mSASSS over time (B = 8.24, 95% CI: 4.38, 12.09, P < 0.01). 
Conclusion. In this prospective cohort study, no gender-attributable differences in disease activity or physical function over time were found. However, radiographic damage was more severe in males. Furthermore, males had a better QoL over time.},
  author       = {Webers, Casper and Essers, Ivette and Ramiro, Sofia and Stolwijk, Carmen and Landewé, Robert and van der Heijde, Désirée and Van den Bosch, Filip and Dougados, Maxime and van Tubergen, Astrid},
  issn         = {1462-0324},
  journal      = {RHEUMATOLOGY},
  keywords     = {sex,ankylosing spondylitis,gender,epidemiology,longitudinal studies,QUALITY-OF-LIFE,HEALTH SURVEY SF-36,DISEASE-ACTIVITY,AXIAL SPONDYLOARTHRITIS,RADIOGRAPHIC PROGRESSION,COHORT,INDEX,BATH,SPONDYLARTHRITIS,SYNDESMOPHYTES},
  language     = {eng},
  number       = {3},
  pages        = {419--428},
  title        = {Gender-attributable differences in outcome of ankylosing spondylitis : long-term results from the Outcome in Ankylosing Spondylitis International Study},
  url          = {http://dx.doi.org/10.1093/rheumatology/kev340},
  volume       = {55},
  year         = {2016},
}

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