Sex: a major predictor of remission in early rheumatoid arthritis?

Forslind, Kristina; Hafström, Ingiäld; Ahlmén, Monica; Svensson, Björn

doi:10.1136/ard.2006.056937

Cited by 207 publications

(198 citation statements)

References 27 publications

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“…In particular, we were unable to adjust for the severity of comorbid conditions. Our findings add further support to previous studies that reported a more favorable outcome for male RA patients compared to female RA patients (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). We have also highlighted the importance of examining such questions using longitudinally collected data, and with the aid of novel analytical techniques.…”

Section: Discussionsupporting

confidence: 88%

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Influence of age and sex on functional outcome over time in a cohort of patients with recent‐onset inflammatory polyarthritis: Results from the Norfolk arthritis register

Camacho¹,

Verstappen²,

Lunt³

et al. 2011

Arthritis Care & Research

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Objective. It has been found that women with rheumatoid arthritis (RA) have a poorer prognosis than men. However, the impact of age at symptom onset is unclear. We investigated the relationship between these factors and functional disability in patients with recent-onset inflammatory polyarthritis (IP). Methods. A total of 3,666 patients (66% women) were registered with the Norfolk Arthritis Register between 1990 and 2008. Functional disability was assessed using the Health Assessment Questionnaire (HAQ), adjusted for age at HAQ completion. Linear random-effects models were used to examine HAQ score over time, by sex and age at symptom onset (early ‫؍‬ age <55 years, late ‫؍‬ age 55-74 years, very late ‫؍‬ age >75 years). Results. Women had higher HAQ scores over time than men (mean difference 0.29; 95% confidence interval [95% CI] 0.25, 0.34). Men with late-onset IP had lower baseline HAQ scores than men with early onset (mean difference ؊0.14; 95% CI ؊0.29, ؊0.001). Women had comparable baseline HAQ scores at all ages of onset. Both sexes showed the greatest rate of disability progression in patients with very late onset. Those with early onset had a steady level of disability over time. Adjustment for treatment received, comorbidities, and RA subgroup analysis produced results that were largely similar to the initial analysis. Conclusion. Female patients have higher HAQ scores than male patients; patients with early symptom onset show the smallest sex difference. Older age at symptom onset is associated with an increasingly steep trajectory of disability progression. The impact of sex on outcome is evident at baseline, whereas the impact of age at symptom onset becomes apparent during long-term followup.

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Section: Discussionsupporting

confidence: 88%

“…It has also been reported that, compared to men, women have a poorer outcome in terms of functional outcome and disease activity (2)(3)(4)(5)(6)(7)(8)(9)(10)(11), although no sex difference in terms of radiographic damage has been reported (5,10).…”

Section: Introductionmentioning

confidence: 99%

Influence of age and sex on functional outcome over time in a cohort of patients with recent‐onset inflammatory polyarthritis: Results from the Norfolk arthritis register

Camacho¹,

Verstappen²,

Lunt³

et al. 2011

Arthritis Care & Research

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“…Results of other studies suggest that women have higher disease activity than men due to the influence of estrogens on the immune system (11,57). Our data show a trend toward a difference between premenopausal and postmenopausal women and men (Table 3).…”

Section: Discussionsupporting

confidence: 66%

A clinical pharmacogenetic model to predict the efficacy of methotrexate monotherapy in recent‐onset rheumatoid arthritis

Wessels

Kooij

Cessie

et al. 2007

Arthritis & Rheumatism

222

152

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Objective. To develop a clinical pharmacogenetic model to predict the efficacy of methotrexate (MTX) in rheumatoid arthritis (RA).Methods. Two hundred five patients with newly diagnosed RA and active disease were treated with MTX (initiated at a dosage of 7.5 mg/week and increased to 15 mg/week after 4 weeks) and folic acid (1 mg/day). If the Disease Activity Score (DAS) was >2.4 at 3 months, the dosage of MTX was increased up to 25 mg/week. Twenty-four baseline variables possibly influencing disease state and drug response were selected. In addition, 17 polymorphisms in 13 genes related to the MTX mechanism of action, purine and pyrimidine synthesis, were determined. Factors were compared between responders (defined as patients with a DAS <2.4 at 6 months) and nonresponders. In case of differences, a stepwise selection procedure identified the predictors for response. A clinical score was designed by simplifying regression coefficients of the independent variables. Cutoff levels were chosen based on the clinical score, and positive and negative response rates were calculated. An evaluation of the model was performed in a second group of patients.Results. The model for MTX efficacy consisted of sex, rheumatoid factor and smoking status, the DAS, and 4 polymorphisms in the AMPD1, ATIC, ITPA, and MTHFD1 genes. This prediction model was transformed into a scoring system ranging from 0 to 11.5. Scores of <3.5 had a true positive response rate of 95%. Scores of >6 had a true negative response rate of 86%. Sixty percent of the patients were categorized as either responders or nonresponders, whereas 32% of the patients were categorized using a nongenetic model. Evaluation of the model in 38 additional patients with RA supported the results.Conclusion. This study established a model for predicting the efficacy of MTX in patients with RA. This pharmacogenetic model may lead to better-tailored initial treatment decisions in patients with RA.

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“…This finding emphasizes that the long lasting rheumatoid arthritis patients prone the thrombosis. Based on the gender this study showed that the female more affected by rheumatoid arthritis this findings were in a consistence with several studies done in different countries [4] [26] [27] [28] [29] [30]. The most common limitations in this study that the number of cases and shortage of the study duration.…”

Section: Discussionmentioning

confidence: 55%

Association of Fibrinogen, Erythrocyte Sedimentation Rate and C-Reactive Protein Levels with Rheumatoid Arthritis

Babikir¹,

Gaufri²

2017

OALib

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Background: Many studies were made the association between the extent of the inflammatory response, increase fibrinogen level and hypercoagulability in rheumatoid arthritis. The current study aims to the investigation and finds the association of the fibrinogen, ESR and CRP levels in Sudanese patients with rheumatoid arthritis. Material and Methods: This is a case-control study, conducted at Modern Medical Center, Khartoum, Sudan, during January 2016. Totally 100 participants were chosen for this study, among them 50 were known Sudanese patients professionally diagnosed with rheumatoid arthritis as case group, and the other 50 participants were normal healthy subjects as control group; their age and gender coordinated with case group. 3 ml of blood was collected in Tri Sodium citrate container, and other 3 ml in plain container. Platelet poor plasma prepared by centrifugation of tri sodium citrate container, and then plasma separated to estimate fibrinogen. Serum was prepared form clotted blood to measure CRP. The ESR was done by Westergren tube from citrated blood in one hour .The data were collected by structured interview and questionnaire, and then analyzed by using a computer program statistical package for social sciences (SPSS) version 20. Results: Significant elevated of the plasma fibrinogen, CRP levels and ESR were observed in subjects with rheumatoid arthritis in comparison with that normal control group with (p value 0.000). Conclusion: This study has shown that rheumatoid arthritis lead to increase level of fibrinogen, ESR and CRP. This abnormality could be contributed to the hypercoagulability phenomenon.

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Sex: a major predictor of remission in early rheumatoid arthritis?

Cited by 207 publications

References 27 publications

Influence of age and sex on functional outcome over time in a cohort of patients with recent‐onset inflammatory polyarthritis: Results from the Norfolk arthritis register

Influence of age and sex on functional outcome over time in a cohort of patients with recent‐onset inflammatory polyarthritis: Results from the Norfolk arthritis register

A clinical pharmacogenetic model to predict the efficacy of methotrexate monotherapy in recent‐onset rheumatoid arthritis

Association of Fibrinogen, Erythrocyte Sedimentation Rate and C-Reactive Protein Levels with Rheumatoid Arthritis

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