Impact of sex and gender on axSpA diagnosis and outcomes

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-09-01 DOI:10.1016/j.berh.2023.101875

Samantha O. Kohn , Abeera Azam , Lauren E. Hamilton , Stephanie R. Harrison , Elizabeth R. Graef , Kristen J. Young , Helena Marzo-Ortega , Jean W. Liew

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Abstract

Axial spondyloarthritis (axSpA) was historically considered a disease of men, largely due to the recognition of a more severe, progressive phenotype, ankylosing spondylitis (AS; or radiographic axSpA, r-axSpA) aiding the clinical diagnosis [[1], [2]]. Data demonstrating the near equal prevalence of axSpA in women only started to emerge in the last decades, highlighting intrinsic differences in disease phenotype, and clinical and imaging characteristics between sexes, which partly explain the issue of underdiagnosis in women. Similar to the evolving understanding of spondyloarthritis and the diseases that term describes, the concepts of gender and sex also warrant further clarification to accurately assess their potential role in disease pathophysiology and phenotypic expression. This narrative review delves into the most recent evidence from the literature on the true prevalence of sex differences in axSpA, and the impact of sex and gender on diagnosis, disease characteristics and treatment response in this, still underserved, chronic disease.

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性别和性别对axSpA诊断和结局的影响。

轴性脊柱炎(axSpA)历来被认为是一种男性疾病，主要是由于认识到更严重的进行性表型强直性脊柱炎(AS;或x线axSpA, r-axSpA)辅助临床诊断[1,2]。显示axSpA在女性中几乎相同患病率的数据在过去几十年才开始出现，突出了疾病表型、临床和影像学特征在性别之间的内在差异，这部分解释了女性诊断不足的问题。类似于对脊椎关节炎和术语所描述的疾病的不断发展的理解，性别和性别的概念也需要进一步澄清，以准确地评估它们在疾病病理生理和表型表达中的潜在作用。这篇叙述性综述深入研究了axSpA中性别差异真实患病率的最新文献证据，以及性别和性别对这种仍然服务不足的慢性疾病的诊断、疾病特征和治疗反应的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.