Aurrecoechea E, llorcadiaz J , Diezlizuain ML , Mcgwin G. Jr and Calvo-alen J
Objective: To evaluate the impact of gender in the quality of life (QOL) of rheumatoid arthritis (RA) patients and the factors associated with such effect.
Methods: Seventy RA patients of each gender were cross-sectionally evaluated as per pre-established protocol: medical history review, standardized disease severity measurements, and comprehensive psychological and disease-related behaviors and coping strategies assessment. QOL was assessed with the SF-36 questionnaire. Univariable and multivariable analyses were performed to examine the contribution of gender and other variables to QOL.
Results: Both groups were comparable regarding age at diagnosis, disease duration, disease activity, and radiological damage. Women showed higher functional impairment (mHAQ: 0.89 ± 2.6 vs. 0.22±0.9, p=0.04), higher prevalence of depression and of osteoporosis, as well as higher scores in the Beck scale (10.7 ± 7.52 vs. 7.8 ± 6.8, p=0.016) but not in other psychological and behavioral variables. In the SF-36, women also showed a greater impairment than men in physical functioning (PF) (57.7 ± 22.1 vs. 67.3 ± 22.7; p=0.01), general health (GH) (41.3 ± 21.7 vs. 50.0 ± 24.3, p=0.02), mental health (MH) (63.7 ± 22.0 vs. 71.8 ± 21.1, p=0.02) and physical component summary score (PCS) (39.3 ± 8.9 vs. 42.4 ± 9.3, p=0.04). Female gender remained significantly associated with poorer PF in multivariable analysis even after adjusting for the Beck Scale (p=0.08), and osteoporosis (p=0.09).
Conclusions: Female RA patients have lower QOL levels than their male counterparts. Depression and osteoporosis may play an important role in this effect. These data should be taken into account in the management of these patients.
Main findings -Gender medicine is a new paradigm of studying chronic diseases. -RA patients of both genders present similar biological and immunological features but women experience poorer QOL. -This is the first study on gender differences in RA examining two sets of RA patients evaluated comprehensively using a standardized protocol inclusive of clinical, ancillary, functional, QOL and psychosocial variables.