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Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients
Emerging evidence suggests that axial spondyloarthritis (axSpA) should not be seen as a predominantly male disease, as the non-radiographic form occurs with roughly equal frequency in women and men. However, men and women experience this disease differently. The purpose of this review is to highligh...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655606/ https://www.ncbi.nlm.nih.gov/pubmed/34876490 http://dx.doi.org/10.1136/rmdopen-2021-001681 |
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author | Chimenti, Maria-Sole Alten, Rieke D'Agostino, Maria-Antonieta Gremese, Elisa Kiltz, Uta Lubrano, Ennio Moreno, Mireia Pham, Thao Ramonda, Roberta Spinelli, Francesca-Romana Perella, Chiara Andreoli, Laura |
author_facet | Chimenti, Maria-Sole Alten, Rieke D'Agostino, Maria-Antonieta Gremese, Elisa Kiltz, Uta Lubrano, Ennio Moreno, Mireia Pham, Thao Ramonda, Roberta Spinelli, Francesca-Romana Perella, Chiara Andreoli, Laura |
author_sort | Chimenti, Maria-Sole |
collection | PubMed |
description | Emerging evidence suggests that axial spondyloarthritis (axSpA) should not be seen as a predominantly male disease, as the non-radiographic form occurs with roughly equal frequency in women and men. However, men and women experience this disease differently. The purpose of this review is to highlight sex-associated and gender-associated differences in the patient’s journey through the diagnosis and management of axSpA, in order to increase the awareness about the unmet needs of female axSpA patients. Female patients experience a longer diagnostic delay compared with men, possibly due to the different pattern of clinical presentations across genders. Therefore, it is crucial to sensitise physicians to pay attention and identify the red flags of axSpA in women and promote early referral to a rheumatologist. Women with a diagnosis of axSpA experience greater limitations in physical function, although they have less structural spinal damage compared with men. Women tend to have less adherence and a lower response to treatment, so more gender-oriented data are needed about drugs used for axSpA, especially biological disease-modifying antirheumatic drugs. Lifestyle factors have a strong impact on the disease course. Interventions regarding physical activity, smoking cessation and diet should be communicated to the patients, with particular attention to the gender-related cultural background. Patients of childbearing age living with axSpA should be engaged in a discussion about reproductive health, in terms of preservation of fertility, management of pregnancy and delivery and use of biologic drugs during pregnancy and breastfeeding. |
format | Online Article Text |
id | pubmed-8655606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-86556062021-12-27 Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients Chimenti, Maria-Sole Alten, Rieke D'Agostino, Maria-Antonieta Gremese, Elisa Kiltz, Uta Lubrano, Ennio Moreno, Mireia Pham, Thao Ramonda, Roberta Spinelli, Francesca-Romana Perella, Chiara Andreoli, Laura RMD Open Spondyloarthritis Emerging evidence suggests that axial spondyloarthritis (axSpA) should not be seen as a predominantly male disease, as the non-radiographic form occurs with roughly equal frequency in women and men. However, men and women experience this disease differently. The purpose of this review is to highlight sex-associated and gender-associated differences in the patient’s journey through the diagnosis and management of axSpA, in order to increase the awareness about the unmet needs of female axSpA patients. Female patients experience a longer diagnostic delay compared with men, possibly due to the different pattern of clinical presentations across genders. Therefore, it is crucial to sensitise physicians to pay attention and identify the red flags of axSpA in women and promote early referral to a rheumatologist. Women with a diagnosis of axSpA experience greater limitations in physical function, although they have less structural spinal damage compared with men. Women tend to have less adherence and a lower response to treatment, so more gender-oriented data are needed about drugs used for axSpA, especially biological disease-modifying antirheumatic drugs. Lifestyle factors have a strong impact on the disease course. Interventions regarding physical activity, smoking cessation and diet should be communicated to the patients, with particular attention to the gender-related cultural background. Patients of childbearing age living with axSpA should be engaged in a discussion about reproductive health, in terms of preservation of fertility, management of pregnancy and delivery and use of biologic drugs during pregnancy and breastfeeding. BMJ Publishing Group 2021-12-06 /pmc/articles/PMC8655606/ /pubmed/34876490 http://dx.doi.org/10.1136/rmdopen-2021-001681 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Spondyloarthritis Chimenti, Maria-Sole Alten, Rieke D'Agostino, Maria-Antonieta Gremese, Elisa Kiltz, Uta Lubrano, Ennio Moreno, Mireia Pham, Thao Ramonda, Roberta Spinelli, Francesca-Romana Perella, Chiara Andreoli, Laura Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title | Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title_full | Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title_fullStr | Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title_full_unstemmed | Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title_short | Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
title_sort | sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients |
topic | Spondyloarthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655606/ https://www.ncbi.nlm.nih.gov/pubmed/34876490 http://dx.doi.org/10.1136/rmdopen-2021-001681 |
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