Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine, Stockholm 17176, Sweden.
Ann Rheum Dis. 2012 Jul;71(7):1203-6. doi: 10.1136/annrheumdis-2011-200947. Epub 2012 Apr 13.
To determine whether men and women with rheumatoid arthritis are prescribed anti-tumour necrosis factor (anti-TNF) treatment at different levels of disease activity.
Data from the Swedish national biologics registry ARTIS were used to analyse characteristics of patients' disease at the start of the first anti-TNF treatment. Means for men and women were compared using t-tests, and non-normally distributed covariates were compared using the Wilcoxon rank-sum test. Linear regression models, adjusted for age and calendar year, were used to investigate the association between sex and each disease activity measurement.
Women were younger and had longer disease duration at treatment start than men. Tender joint count, erythrocyte sedimentation rate, patient's global assessment, patient-reported pain and health assessment questionnaire scores were significantly higher in women, whereas men had a higher level of C-reactive protein (p<0.05 for all comparisons). Swollen joint count and physician's global assessment did not differ by sex.
For women with rheumatoid arthritis, treatment with anti-TNF therapy was initiated at a higher level of subjective disease activity than for men, but at the same level of physician-reported disease activity. These data imply that patients' subjectively experienced disease activity may be discounted in the treatment decision.
确定男性和女性类风湿关节炎患者在疾病活动度不同水平时是否接受抗肿瘤坏死因子（anti-TNF）治疗。
使用瑞典国家生物制剂注册处 ARTIS 的数据来分析首次接受抗 TNF 治疗时患者疾病的特征。使用 t 检验比较男性和女性的平均值，使用 Wilcoxon 秩和检验比较非正态分布的协变量。使用调整年龄和日历年份的线性回归模型，研究性别与每种疾病活动测量之间的关联。
女性在治疗开始时比男性更年轻，且疾病持续时间更长。女性的压痛关节计数、红细胞沉降率、患者整体评估、患者报告的疼痛和健康评估问卷评分明显更高，而男性的 C 反应蛋白水平更高（所有比较的 p<0.05）。肿胀关节计数和医生整体评估在性别方面没有差异。
对于患有类风湿关节炎的女性，与男性相比，抗 TNF 治疗的起始水平更高，提示患者主观疾病活动度可能在治疗决策中被低估。
