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[炎症性风湿性疾病诊断与治疗中的性别差异]

[Gender-specific differences in the diagnosis and treatment of inflammatory rheumatic diseases].

作者信息

Albrecht Katinka, Strangfeld Anja

机构信息

Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.

出版信息

Inn Med (Heidelb). 2023 Aug;64(8):744-751. doi: 10.1007/s00108-023-01484-3. Epub 2023 Mar 6.

Abstract

BACKGROUND

Gender differences in the diagnosis and treatment of various diseases are increasingly being researched with the aim of optimizing treatment strategies and improving individual treatment success.

METHODS

This paper summarizes the existing literature for gender differences in inflammatory rheumatic diseases.

RESULTS

Many, but not all, inflammatory rheumatic diseases occur more frequently in women than in men. Women more often have a longer duration of symptoms until diagnosis than men, which may be due to different clinical and radiological presentations. Across diseases, women more often have lower remission and treatment response rates to antirheumatic medication compared to men. Discontinuation rates are also higher in women than in men. Whether women are more likely to develop anti-drug antibodies to biologic disease-modifying antirheumatic drugs is still unclear. For Janus kinase inhibitors, there is no evidence of differential treatment response to date.

CONCLUSION

Whether individual dosing regimens and gender-adapted remission criteria are also required in rheumatology cannot be deduced from the evidence available to date.

摘要

背景

为优化治疗策略并提高个体治疗成功率,人们越来越多地研究各种疾病在诊断和治疗方面的性别差异。

方法

本文总结了关于炎性风湿性疾病性别差异的现有文献。

结果

许多(但并非所有)炎性风湿性疾病在女性中的发病率高于男性。与男性相比,女性在诊断前症状持续时间往往更长,这可能是由于不同的临床和放射学表现所致。在各种疾病中,与男性相比,女性对抗风湿药物的缓解率和治疗反应率往往更低。女性的停药率也高于男性。女性是否更易产生针对生物性改善病情抗风湿药物的抗药抗体仍不清楚。对于 Janus 激酶抑制剂,目前尚无证据表明存在不同的治疗反应。

结论

目前可得的证据无法推断出在风湿病学中是否也需要个体化给药方案和适应性别的缓解标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ceb/10366264/7efd94439f6d/108_2023_1484_Fig1_HTML.jpg

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