Chinese registry of rheumatoid arthritis (CREDIT) V: sex impacts rheumatoid arthritis in Chinese patients

Nan Jiang; Qin Li; Hongbin Li; Yongfei Fang; Lijun Wu; Xinwang Duan; Jian Xu; Cheng Zhao; Zhenyu Jiang; Yanhong Wang; Qian Wang; Xiaomei Leng; Mengtao Li; Xinping Tian; Xiaofeng Zeng; CREDIT Co-Authors

doi:10.1097/CM9.0000000000002110

Chinese registry of rheumatoid arthritis (CREDIT) V: sex impacts rheumatoid arthritis in Chinese patients

Chin Med J (Engl). 2022 Sep 20;135(18):2210-2217. doi: 10.1097/CM9.0000000000002110.

Authors

Nan Jiang¹, Qin Li², Hongbin Li³, Yongfei Fang⁴, Lijun Wu⁵, Xinwang Duan⁶, Jian Xu⁷, Cheng Zhao⁸, Zhenyu Jiang⁹, Yanhong Wang¹⁰, Qian Wang¹, Xiaomei Leng¹, Mengtao Li¹, Xinping Tian¹, Xiaofeng Zeng¹; CREDIT Co-Authors

Affiliations

¹ Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.
² Department of Rheumatology, the First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, China.
³ Department of Rheumatology, the Affiliated Hospital of Inner Mongolia Medical College, Hohhot, Inner Mongolia 010050, China.
⁴ Department of Rheumatology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
⁵ Department of Rheumatology and Immunology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China.
⁶ Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
⁷ Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
⁸ Department of Rheumatology, The First Affiliated Hospital of Guangxi Medical University, Manning, Guangxi 530021, China.
⁹ Department of Rheumatology, The First Hospital of Jilin University, Changchun, Jilin 130021, China.
¹⁰ Department of Epidemiology and Bio-Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China.

Abstract

Background: The impact of sex on the clinical manifestations of rheumatoid arthritis (RA) were diversely reported in the literature. The Chinese Registry of rhEumatoiD arthrITis provides a platform for the investigation of this issue in Chinese patients.

Methods: Demographic and clinical parameters were collected from all enrolled patients with RA and from patients with early RA (disease duration ≤6 months). The differences in data regarding disease activity, comorbidities, and medications for RA were compared between men and women. The proportions of patients who achieved remission and low disease activity were compared at enrollment and during 3-, 6-, and 12-month follow-up visits.

Results: A total of 11,564 patients were enrolled, 83.6% of whom were female. In all the enrolled patients and patients with early RA, C-reactive protein (CRP, 12.0 vs . 6.7 mg/L), pain visual analogue scale (4.8 vs . 4.5), patient's and physician's global assessment (4.9 vs . 4.5 and 4.9 vs . 4.5), 28-joint disease activity score using DAS28-CRP (4.3 vs . 4.0) simplified disease activity index (21.9 vs . 19.9), and clinical disease activity index (19.3 vs . 18.0) were significantly higher in men than in women. Additionally, the swollen joint count/tender joint count and DAS28 using erythrocyte sedimentation rate were higher in male patients than in female patients with early RA. More female patients with early RA reached the treatment target at baseline than male patients (23.4% vs . 18.2%, assessed by CDAI). At 3 months, 6 months, and 12 months, the proportion of remission and treatment target achievement was similar in both sexes. Coronary artery disease (CAD) and stroke were more frequent in men than in women.

Conclusions: In Chinese patients with RA, men were found to have more active disease, as well as more cases of CAD and stroke. Therefore, sex should be carefully considered during the personalization of RA treatment.

MeSH terms

Antirheumatic Agents* / therapeutic use
Arthritis, Rheumatoid* / drug therapy
East Asian People
Female
Humans
Male
Registries
Severity of Illness Index
Stroke* / drug therapy

Substances

Antirheumatic Agents