Clinical and epidemiological differences between men and women with systemic sclerosis: a study in a Spanish systemic sclerosis cohort and literature review

Fecha de publicación: 01/09/2017

Autores de IIS La Fe

José Antonio Todolí Parra

Autor

Participantes ajenos a IIS La Fe

Freire, M
Rivera, A
Sopeña B
Tolosa Vilella C
Guillen-Del Castillo, A
Colunga Argüelles D
Callejas Rubio JL
Rubio Rivas M
Trapiella Martínez L
Rodríguez Carballeira M
Iniesta Arandia N
García Hernández FJ
Egurbide Arberas MV
Sáez Comet L
Vargas Hitos JA
Ríos Blanco JJ
Marín Ballvé A
Pla Salas X
Madroñero Vuelta AB
Ruiz Muñoz M
Fonollosa Pla V
Simeón Aznar CP
RESCLE Investigators, Autoimmune D

Grupos

Investigacion clínica en enfermedades crónicas e Infección por el VIH

Investigador establecido

Marta Montero Alonso

Abstract

Objective. The low overall prevalence of systemic sclerosis (SSc) and the low proportion of male patients have resulted in a scarcity of studies assessing sex differences in Ssc patients, and contradictory results have often been show among those studies that have been performed. Methods. A prospective study was conducted with the Spanish RESCLE register to analyse the influence of gender on survival of SSc patients. Results. In total, 1506 SSc patients (1341 women, 165 men) were recruited from 21 centres. Older age at onset (OR 1.02), shorter time from onset to diagnosis (OR 0.96), smoking (OR 2.57), interstitial lung disease (ILD) (OR 1.58), less predisposition to sicca syndrome and to antinuclear antibody positivity (OR 0.29 and 0.43, respectively), and higher compliance with the ACR 1980 criteria (OR 1.79) were independently associated with the male sex. During follow-up, 30.4% of men versus 14.6% of women died (p<0.001). Survival at 10 years from the onset of symptoms was 75.3% for men and 92.9% for women (p<0.001), and the difference remained after selecting only SSc-related deaths (85.6% vs. 96.1%, p<0.001). The mortality predictive factors were diffuse SSc (OR 2.26), ILD (OR 1.82), digital ulcers (OR 1.38), tendon friction rubs (OR 1.74), male sex (OR 1.53), increased age at onset (OR 1.13) and isolated PH (considering only deaths from diagnosis), both in the overall (OR 3.63) and female cohorts (OR 3.97). The same risk factors were observed in the male cohort, except for isolated PH and ILD. Conclusion. The present study confirms the existence of epidemiological, clinical, laboratory and prognostic gender differences in systemic sclerosis patients.

Datos de la publicación

ISSN/ISSNe:: 0392-856X, 1593-098X
Tipo:: Review
Páginas:: 89-97
DOI:
PubMed:: 28980905
Factor de Impacto:: 1,164 SCImago ℠
Cuartil:: Q2 SCImago ℠

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Filiaciones

Freire, M:: Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain.

Complexo Hosp Univ Vigo, Thrombosis & Vasculitis Unit, Dept Internal Med, Estr Clara Campoamor 341, Vigo 36312, Spain
Rivera, A:: Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain

Complexo Hosp Univ Vigo, Thrombosis & Vasculitis Unit, Dept Internal Med, Estr Clara Campoamor 341, Vigo 36312, Spain

Complexo Hosp Univ Santiago, Dept Internal Med, Santiago De Compostela, Spain
Sopeña B:: Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago, Spain
Tolosa Vilella C:: Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
Guillen-Del Castillo, A:: Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain

Hosp Univ Val DHebron, Dept Internal Med, Autoimmune Unit, Barcelona, Spain
Colunga Argüelles D:: Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
Callejas Rubio JL:: Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
Rubio Rivas M:: Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Trapiella Martínez L:: Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain
Todolí Parra JA:: Department of Internal Medicine, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Rodríguez Carballeira M:: Department of Internal Medicine, Hospital Universitari Mútua Terrassa, Barcelona, Spain
Iniesta Arandia N:: Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain
García Hernández FJ:: Collagenosis and Pulmonary Hypertension Unit, Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain
Egurbide Arberas MV:: Department of Internal Medicine, Hospital Universitario Cruces, Barakaldo, Spain
Sáez Comet L:: Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
Vargas Hitos JA:: Department of Internal Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain
Ríos Blanco JJ:: Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
Marín Ballvé A:: Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Pla Salas X:: Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
Madroñero Vuelta AB:: Department of Internal Medicine, Hospital General San Jorge, Huesca, Spain
Ruiz Muñoz M:: Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
Fonollosa Pla V:: Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain
Simeón Aznar CP:: Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Val D'Hebron, Barcelona, Spain
RESCLE Investigators, Autoimmune D:: RESCLE investigators, Autoimmune Diseases Study Group (GEAS)