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Gender differences in early systemic sclerosis patients: a report from the EULAR scleroderma trials and research
Patricia E Carreira1, Loreto Carmona2, Beatriz E Joven3
1Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain. carreira@h12o.es.
In early systemic sclerosis (SSc), men often exhibit more severe disease signs and symptoms than women. These differences are particularly noted in the limited cutaneous subset, impacting clinical presentation and organ involvement.
Area of Science:
- Rheumatology
- Immunology
- Dermatology
Background:
- Systemic sclerosis (SSc) is a complex autoimmune disease characterized by fibrosis, vascular abnormalities, and immune dysregulation.
- Clinical presentation and disease progression in SSc can vary significantly between sexes.
- Understanding these sex-based differences is crucial for tailored patient management.
Purpose of the Study:
- To delineate the clinical differences between men and women in early systemic sclerosis (<3 years duration).
- To analyze these differences across various SSc disease subsets.
- To identify potential implications for clinical practice and patient management.
Main Methods:
- Cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research (EUSTAR) database.
- Inclusion of patients meeting preliminary ACR 1980 classification criteria for SSc with early disease duration (<3 years).
- Descriptive and bivariate analyses of SSc-related variables, including antibodies, subsets, disease activity, and organ involvement.
Main Results:
- A cohort of 1,027 early SSc patients was analyzed (80% women, 90% Caucasian).
- Men with early SSc more frequently presented with active disease, diffuse cutaneous subset, anti-Scl-70 antibodies, elevated acute phase reactants, and muscular/pulmonary involvement compared to women.
- These sex-based differences were significant in the limited SSc subset but not in the diffuse subset.
Conclusions:
- Men with early systemic sclerosis tend to exhibit more severe disease manifestations.
- In the limited SSc subset, men may present with clinical features overlapping with the diffuse SSc subgroup.
- Recognizing these sex-specific differences can aid in optimizing treatment strategies for individual patients.
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