Early rheumatoid arthritis: Does gender influence disease expression?

Objective To investigate whether gender is an independent factor associated with disease expression in early rheumatoid arthritis (RA) patients. Methods 438 patients with early RA (disease duration less than one year) were studied. They all were patients with early RA who presented at the Rheumatology Clinic of the University Hospital of Ioannina during the period 1991/2000. All patients fulfilled the American College of Rheumatology criteria for RA. The demographic, clinical, laboratory, radiological and therapeutic characteristics of the disease at diagnosis, and at the last follow-up were analyzed according to gender. Results We studied 312 women and 126 men with early RA. The female to male ratio was 2.5:1 and the mean age at diagnosis was 49.4 +/- 14.9 years for women and 55.3 +/- 15.6 years for men (P < 0.0003). Women had a longer duration of follow-up (P < 0.0003). There were no differences between genders in the general symptoms or the symmetricity of joint involvement at disease onset. However, at disease onset women had a higher erythrocyte sedimentation rate (ESR) (> 30 mm/1(st) hour), although there were no significant differences between the two groups concerning the rest of the clinical, laboratory and radiological findings. At the last follow-up women still had a higher ESR (> 30 mm/1(st) hour), but no significant differences were found between the two groups concerning the rest of the parameters investigated independently of the follow-up duration. Finally, women and men showed the same degree of radiological changes and functional ability and were treated similarly except for the more frequent use of hydroxychloroquine in women. Conclusion It seems that gender does not significantly influence the expression of RA.