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- Title
GENDER DIFFERENCES IN ORGAN INVOLVEMENT AND SURVIVAL IN SYSTEMIC SCLEROSIS – EXPERIENCE OF A EUSTAR CENTER.
- Authors
GROSEANU, Laura; PETRE, Andreea; BALANESCU, Andra; BOJINCA, Violeta; OPRIS-BELINSKI, Daniela; BERGHEA, Florian; SAULESCU, Ioana; MAZILU, Diana; ILIESCU, Sanziana Daia; BORANGIU, Andreea; CONSTANTINESCU, Cosmin; COBILINSCHI, Claudia; NEGRU, Maria Magdalena; ABOBULUI, Mihai; IONESCU, Ruxandra
- Abstract
Introduction. The low overall prevalence of systemic sclerosis (SSc) and the low proportion of male patients have resulted in a scarcity of studies assessing sex differences in SSc patients, and contradictory results have often been observed. Material and method. We performed a retrospective observational study using data extract from the EULAR scleroderma trials and research (EUSTAR) cohort 096 . We looked at sex influence on disease characteristics at baseline and then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival. Results. 173 patients with SSc were available for the baseline analyses. In the longitudinal analysis after a mean follow-up of 3.5(±0.65) years, male sex was associated with a higher risk of scleroderma renal crisis (OR:9.45 (1.49 to 59.69); p = 0.004), digital contractures (OR:8.2 (3.1 to 21.9); p < 0.001), arrhythmias (OR: 3.37 (1.36 to 8.34); p = 0.006), pulmonary fibrosis (OR: 3.56, (1.51 to 8.41); p = 0.003), pulmonary hypertension (OR: 3.01 (1.19 to 7.59); p = 0.016), severe vascular involvement (OR:2.86, (1.22 to 6.73); p = 0.013) and low ventricular ejection fraction (OR: 2.84, (1.2 to 6.73); p = 0.014). Males had significantly reduced survival time after diagnosis (p = 0.004). The most frequent causes of death were scleroderma renal crisis in males and pulmonary hypertension in females. Conclusions. Although more common in women, SSc appears as strikingly more severe in men. Our results demonstrate a higher risk of severe organ involvement and poor prognosis in men. These results raise the point of including sex in the management and the decision-making process.
- Subjects
SYSTEMIC scleroderma; SEX factors in disease; SCLERODERMA (Disease); VENTRICULAR ejection fraction; PULMONARY fibrosis; PULMONARY hypertension
- Publication
Romanian Journal of Rheumatology / Revista Romana de Reumatologie, 2021, Vol 30, Issue 2, p68
- ISSN
1843-0791
- Publication type
Article
- DOI
10.37897/RJR.2021.2.4