A study on comparison of gender-based prevalence and severity at presentation in spondyloarthritis in a tertiary care rheumatic center

Introduction: Spondyloarthritis (or spondyloarthropathy) is the overall name for a family of inflammatory rheumatic diseases that can affect the spine and joints, ligaments and tendons. These diseases can cause fatigue and pain or stiffness in the back, neck, hands, knees, and ankles as well as inflammation of the eyes, skin, lungs, and heart valves. While there is no course of prevention at this time treatment can reduce discomfort and delay the development of spinal deformities. Aim of the study: The aim of the study was to differentiate gender difference at presentation of spondyloarthritis and to identify markers in determining the severity of disease. Materials and methods: This was a prospective observational study conducted for a period of 6 months at Institute of Rheumatology, Government K.A.P.V. Medical College and MGM Government Hospital. Totally 62 patients were included in the study 31 males and 31 consecutive females with features of spondyloarthritis per ASAS (Assessment of Spondyloarthritis international Society) at first presentation to our clinic were enrolled and their clinical characteristics were analyzed. Results: On comparing disease activity and functional indices between males and females, mean BASDAI was 4.66±1.8 versus 4.98±1.94 (p=0.5), mean BASFI was 4.6±2.3 versus 4.8±2.3 (p=0.7), mean BASMI was3.91±1.94 versus 4.18±2.06 (p=0.4). Out of 31 males, 17 were positive for HLA B27 and 6 out of 31 females were positive for HLA B27 (p=0.04). Conclusion: The pathogenesis of SpA is multifactorial and not yet fully understood. Genetic factors (HLA-B27 and non– HLA-B27 related genes), inflammatory cytokines (e.g. TNF-alpha, IL-1, IL-6, IL-7, IL-17, and IL-23) and environmental triggers (infections, mechanical stress, abnormal intestinal microbiota) play an important role. These different factors and their complex interaction can lead to activation of autoinflammation and autoimmunity and to the new bone formation. Men are more prone to spondyloarthritis when compared with women.