Spondyloarthritis & psoriatic arthritis
Impact of sex on spinal radiographic progression in axial spondyloarthritis: a longitudinal Swiss cohort analysis over a period of 10 years
Authors' conclusion
Spinal radiographic progression in axSpA is more severe in men than in women, with three times higher odds of progression in male patients and an effect that is mediated in part through an increase in baseline radiographic damage.
Study context
- Population
- Axial spondyloarthritis (axSpA) patients in the Swiss Clinical Quality Management cohort with spinal radiographs every 2 years
- Participants
- 505 patients
- Exposure
- Men vs women
- Menn = 317
- Womenn = 188reference
- Outcome
- Spinal radiographic progression (increase of ≥2 modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) units in 2 years)
- Follow-up
- 2 years
Methodological detailslongitudinal, binomial generalised estimating equation models, multiple imputation for missingness
- Longitudinal
- Binomial generalised estimating equation models
- Multiple imputation for missingness
Main finding
As reported in the abstract
Spinal radiographic progression (mSASSS) over 2 years; progression defined as increase of ≥2 mSASSS units in 2 years
P < 0.001
- Male sex, progression, small model not including baseline damage: OR
- 3.41 (95% CI 1.87 to 6.21)
- Male sex, direct effect on spinal progression: OR
- 2.06 (95% CI 1.15 to 3.67)
- Male sex, indirect effect via enhancement of baseline spinal damage: OR
- 1.04 (95% CI 1.01 to 1.07)
- Male sex, after multiple adjustments for covariates: OR
- 1.97 (95% CI 1.04 to 3.71)
Observational data: associations, not effects.
Original publication
Impact of sex on spinal radiographic progression in axial spondyloarthritis: a longitudinal Swiss cohort analysis over a period of 10 years. RMD Open. Published 28 July 2023. doi:10.
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