Gender differences in systemic sclerosis: relationship to clinical features, serologic status and outcomes

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic sclerosis (SSc) predominantly affects females.
• Understanding gender-specific differences is crucial for SSc management.

Purpose of the Study:

• To compare gender differences in a large cohort of SSc patients.
• To analyze demographic, clinical, and survival variations between males and females with SSc.

Main Methods:

• A large single-center cohort of SSc patients was analyzed.
• Demographic features, disease subtype, environmental exposures, autoantibodies, organ involvement, and survival were compared between genders.
• Adjustments were made for cutaneous subsets (diffuse cutaneous [dc] and limited cutaneous [lc]).

Main Results:

• Females presented younger with longer disease duration, more lcSSc, and anti-centromere antibodies.
• Males exhibited more dcSSc, overlap with myositis, smoking, environmental exposures, and severe interstitial lung disease (ILD).
• Males had significantly reduced survival, with ILD and pulmonary hypertension being leading causes of death in males and females, respectively.

Conclusions:

• Significant gender-based disparities exist in SSc presentation, autoantibody profiles, organ involvement, and survival.
• These gender differences offer critical insights into SSc pathogenesis and natural history.