Sex and Management of Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease more common in women than men (3:1). Although sex-based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between sex and RA is still partially lacking. Furthermore, males and females have been demonstrated to differently deal with their chronic pathologies, modifying the perceived sex-based burden of disease. Gender medicine is a newly approach focusing on the impact of gender differences on human physiology, pathophysiology, and clinical features of diseases, analyzing the complex interrelation and integration of sex and psychological and cultural behavior. A better comprehension of possible factors influencing sexual dimorphism in RA susceptibility, pattern of presentation, disease activity, and outcome could contribute to a tailored approach, in order to limit the morbidity of the disease. RA disease activity seems to be higher in women, whereas the response rate to synthetic and biologic disease-modifying therapies appears to be better in males. Moreover, the common strategies for RA management may be affected by concomitant pregnancy or childbearing desire, with particular regard to treatments with potential teratogenic effects or impact on fertility. Finally, comorbidities, such as fibromyalgia, major depression, and osteoporosis, are more frequent in females, while the impact of sex on cardiovascular risk is still controversial. Moving from the role of sex in influencing RA pathogenesis, epidemiology, and disease characteristics, this review explores the evidence on how sex can have an impact on strategies for managing patients with RA.

Dermoscopic patterns of filiform papillae of the tongue in patients with and without connective tissue autoimmune diseases

“…Although gender-based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between gender and RA is still partially lacking. 16,17 Our cohort was predominantly female (94% vs. 6%), possibly because women more often consult a dermatologist; similar to the literature, rheumatoid arthritis is the most frequent CTAD in our hospital.…”

“…The worldwide prevalence of rheumatoid arthritis is approximately 1%, and in Mexico, it affects 1.6% of the general population and is the main reason for consultation in rheumatology services (this value can vary, depending on the geographic region, ranging from 0.7 to 2.8%), and is a chronic and progressive autoimmune disease more common in women than men (3 : 1). Although gender‐based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between gender and RA is still partially lacking …”

Appraisal of the Impact of Rheumatoid Arthritis on the Quality of Life Using Sf-36: A Cross Sectional Study

“…And as verified by the questionnaire it was found that female respondents are more prone to the physical health issues and are having more painful experiences. Exactly as suggested by studies based on the sex differences that women with RA do more worse than men with the same disease 20 . The difference must be due to the physical and emotional strength variations between males and females, in addition, menopause and pre-menopause stage females are naturally prone to low estrogen related bone density disorders like osteoporosis and joint damage 21 .Hence women with chronic RA are at higher risks of osteoporosis and depression.…”

Trojans in Oral Environments: Evidence of Molecular Mimicry in Oral Immunity

“…Collagen is the most tissue presented in the body; it is associated with the skin, kidney, nerves, blood vessels and muscles protecting them against compressive forces [67,68]. Rheumatoid arthritis (RA) is a progressive autoimmune disease that affects directly the collagen by the chronification of inflammation causing a tissue damage (specially cartilage and bone), functional impairment, severe disability and premature mortality [69,70]. Periodontitis is a chronic disease by microbial multispecies insult.…”