Division of Rheumatology (JMD, CSC), Internal Medicine (CMC) and Department of Health Sciences Research (CSC), College of Medicine and Science, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Rheumatol Int. 2019 Dec;39(12):2025-2030. doi: 10.1007/s00296-019-04360-2. Epub 2019 Jul 23.
The objective is to compare the time to fulfillment of 1987 and 2010 ACR/EULAR classification criteria between female and male patients with rheumatoid arthritis (RA) and to assess the potential impact of gender on the time to DMARD therapy. Time from first provider-documented joint swelling to fulfillment of 1987 and 2010 ACR/EULAR criteria was measured in a population-based cohort of adults with incident RA, who were stratified by male or female gender. Disease characteristics, time to start of DMARD therapy, and choice of initial DMARD were compared between groups. The study included 214 patients with RA (148 females and 66 males). Median times from first joint swelling to fulfillment of 1987 (6.5 vs 2.5 days, p = 0.48) and 2010 (1 vs 0 days, p = 0.34) classification criteria were not different between female and male patients overall. There was no difference in time to first DMARD therapy in female vs male patients (15.5 vs 16 days, p = 0.90), and methotrexate was used most frequently as first DMARD in both genders (61% female vs 64% male, p = 0.76). Among the 49 female and 20 male RF/ACPA-negative patients, females experienced a higher median time from first joint swelling to fulfillment of the 1987 (65 vs 11 days, p = 0.063) and 2010 (65 vs 0 days, p = 0.035) classification criteria. Overall, there was no significant delay in meeting 1987 and 2010 ACR/EULAR classification criteria between female and male RA patients, though time to meeting both 1987 and 2010 criteria was slightly longer in males compared with females. Among seronegative patients, females experienced a significant delay to meeting 2010 criteria from first clinically detected synovitis.
目的是比较女性和男性类风湿关节炎（RA）患者达到 1987 年和 2010 年 ACR/EULAR 分类标准的时间，并评估性别对达到 DMARD 治疗时间的潜在影响。在一个基于人群的初诊 RA 成年患者队列中，测量从首次记录关节肿胀到满足 1987 年和 2010 年 ACR/EULAR 标准的时间，这些患者按性别分为男性或女性。比较两组之间的疾病特征、开始 DMARD 治疗的时间和初始 DMARD 的选择。该研究包括 214 例 RA 患者（148 例女性和 66 例男性）。女性和男性患者总体上达到 1987 年（6.5 天与 2.5 天，p=0.48）和 2010 年（1 天与 0 天，p=0.34）分类标准的中位时间无差异。女性患者和男性患者首次 DMARD 治疗时间无差异（15.5 天与 16 天，p=0.90），并且两种性别中最常使用甲氨蝶呤作为初始 DMARD（女性 61%与男性 64%，p=0.76）。在 49 例女性和 20 例 RF/ACPA 阴性患者中，女性从首次关节肿胀到满足 1987 年（65 天与 11 天，p=0.063）和 2010 年（65 天与 0 天，p=0.035）分类标准的中位时间更高。总体而言，女性和男性 RA 患者达到 1987 年和 2010 年 ACR/EULAR 分类标准之间没有明显的延迟，尽管与女性相比，男性达到 1987 年和 2010 年标准的时间稍长。在血清阴性患者中，女性从首次临床检测到滑膜炎到满足 2010 年标准的时间明显延迟。
