Spondyloarthritis & psoriatic arthritis
Sex differences in long-term functional deterioration and permanent disability in spondyloarthritis: a 17-year follow-up from the REGISPON-3 study
Authors' conclusion
Female patients experienced greater long-term functional deterioration despite similar work disability rates at follow-up.
Study context
- Population
- Patients with spondyloarthritis (SpA) from the Spanish REGISPONSER registry (baseline 2004–2007), reassessed 17 years later in REGISPON-3 (2021–2024)
- Participants
- 411 patients
- Exposure
- Female vs male patients with SpA
- Femalen = 140
- Malen = 271reference
- Outcome
- Long-term functional deterioration (BASFI at follow-up, ΔBASFI) and permanent work disability
- Follow-up
- 17 years
Methodological detailsregistry-based, 17-year follow-up, sex-stratified logistic and multivariable linear regression, moderated mediation analysis
- Registry-based
- 17-year follow-up
- Sex-stratified logistic and multivariable linear regression
- Moderated mediation analysis
Main finding
As reported in the abstract
Functional deterioration (ΔBASFI)
Female
1.47
± 2.81
Male
0.38
± 2.57
P < 0.001
Observational data: associations, not effects.
Further findings
Permanent work disability · 17 years · similar rates
P = 0.31
Predictors of disability and ΔBASFI
- Higher Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Radiology Index (BASRI)-total independently associated with disability in both sexes
- Baseline Bath Ankylosing Spondylitis Functional Index (BASFI) and BASDAI predicted ΔBASFI in both sexes; additional predictors in males BASRI-total and occiput-to-wall distance, BASRI-column in females
Indirect effect of bDMARD exposure on ΔBASFI through C reactive protein (CRP) (moderated mediation)
- Significant in male but not female patients, with a significant sex interaction
Original publication
Sex differences in long-term functional deterioration and permanent disability in spondyloarthritis: a 17-year follow-up from the REGISPON-3 study. RMD Open. Published 15 July 2026. doi:10.
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