AB0360F GENDER DIFFERENCES IN CLINICAL CHARACTERISTICS AND COMORBIDITIES AND THEIR IMPACT ON CLINICAL OUTCOME IN KOREAN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background Rheumatoid arthritis (RA) is a chronic auto-immune disease that is more common to female than male. Gender-based differences in clinical features, comorbidities, and disease outcomes have been fragmentarily described. However, systematic analysis focusing on gender differences in a large RA population is scarce. Objectives We aimed to elucidate gender differences in clinical characteristics and comorbidities and their potential impact on clinical outcome in a large Korean cohort of patients with RA. Methods A total of 5,376 RA patients were included from the KORean Observational study Network for Arthritis (KORONA) database. Each patient was examined at baseline and three consecutive years. RA disease activity, functional disability, and quality of life were assessed by disease activity score 28 (DAS28), health assessment questionnaire (HAQ) and EuroQoL-5D (EQ-5D), respectively. The subjective health-related outcomes including visual analog scale (VAS) scores for patient’s and physician’s global health, patient’s pain, fatigue, and sleep disturbance were collected. Clinical characteristics and comorbidities at baseline were compared according to gender. Gender impacts on clinical outcome during the four years were analyzed using generalized estimating equations (GEE) models for repeated measures. In addition, the gender effect on achieving clinical remission was analyzed using Cox-proportional hazards regression. Results At baseline, females (n=4,574) were younger, more erosive, and had longer disease duration than male (n=802). Females showed significantly higher scores in DAS28, HAQ, EQ-5D, and VAS for all patients’ health-related outcomes. In terms of comorbidities, the prevalence of male RA was significantly higher than that of female RA in most illnesses including interstitial lung disease, cardiovascular disease, diabetes and other pulmonary disease except for depression. In the GEE model, gender was found to significantly influence the rate of change of DAS28 (p=0.041), and also independently associated with this outcome (p<0.001) after adjusting for age, disease duration, and baseline DAS28. Females were associated with a reduced rate of achieving DAS28 remission (HR 0.41, 95% CI 0.28-0.58) compared to male. Conclusion In Korean patients with RA, most comorbidities were more prevalent in male than in female. But for RA-related health outcomes, the longitudinal change in disease activity and the rate of achieving clinical remission over time were found to be worse in female RA. References [1] Jawaheer D, Maranian P, Park G, Lahiff M, Amjadi SS, Paulus HE. Disease progression and treatment responses in a prospective DMARD-naive seropositive early rheumatoid arthritis cohort: does gender matter?J Rheumatol2010;37:2475-85 [2] Aurrecoechea E, Llorca Díaz J, Diez Lizuain ML, McGwin G Jr, Calvo-Alen J. Gender-associated comorbidities in rheumatoid arthritis and their impact on outcome: data from GENIRA. Rheumatol Int2017;37:479-85. Disclosure of Interests None declared