Females With Axial Spondyloarthritis Have Longer Diagnostic Delay and Higher Burden of the Disease. Results From the International Map of Axial Spondyloarthritis (IMAS)

Background: To assess gender differences in a large sample of patients included in the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.

Method: IMAS is a cross-sectional online survey (2017-2022) of 5557 unselected axSpA patients from 27 countries. The current analysis assessed differences between males and females for: sociodemographic, health behaviors, disease characteristics, patient-reported outcomes, mental comorbidities, and treatments. Univariable and multivariable logistic regression analysis was used to evaluate the relationship between gender and disease characteristics, patient-reported outcomes, comorbidities, and treatments.

Results: Data from 5555 patients reporting gender were analyzed: 3492 from Europe, 769 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. Globally, 55.4% were females, with higher proportions in South Africa (82.2%) and lower in Asia (20.8%). Compared to males, a lower percentage of females smoked and consumed alcohol. The diagnostic delay was significantly longer (+2.4 years) in females, while the frequency of HLA-B27 positivity of axSpA was lower in females. The use of axSpA pharmacological treatment was more common in females with a higher proportion having ever taken nonsteroidal anti-inflammatory drugs (NSAIDs), conventional synthetic DMARDs (csDMARDs), and biologic DMARDs (bDMARDS).

Conclusions: Identifying the specific disease characteristics associated with gender in patients with axSpA may help to improve the diagnosis and management of the disease, and thereby reduce the disease burden for patients around the world.