PT  - JOURNAL ARTICLE
AU  - Stylianos T.  Panopoulos
AU  - Vasiliki-Kalliopi Bournia
AU  - Petros P.  Sfikakis
TI  - Is Vasculopathy Associated with Systemic Sclerosis More Severe in Men?
AID  - 10.3899/jrheum.120667
DP  - 2012 Nov 01
TA  - The Journal of Rheumatology
PG  - jrheum.120667
4099  - http://www.jrheum.org/content/early/2012/10/27/jrheum.120667.short
4100  - http://www.jrheum.org/content/early/2012/10/27/jrheum.120667.full
AB  - Objective To identify possible differences in morbidity and mortality between men and women with systemic sclerosis (SSc) by examining a homogeneous cohort at a single academic center. Methods Demographic, clinical, and outcome data for all 231 patients of Greek origin with SSc who were examined between 1995 and 2011 in our department (200 women) were recorded in consecutive 3-year intervals from disease onset; data were analyzed retrospectively. Results Factors comparable between sexes were age (yrs ± SD) at disease onset (46 ± 15 vs 46 ± 15), diffuse skin involvement (61.3% of men vs 46.4% of women), and anti-Scl-70 antibody positivity (66.6% of men vs 59.2% of women). Also comparable were prevalence of interstitial lung disease, upper or lower gastrointestinal (GI) tract involvement, and echocardiographic findings during the first, second, and third 3-year intervals from disease onset (2904 patient-yrs). In contrast, vasculopathy occurred earlier in men. During the first 3 years digital ulcers developed in 54% of men versus 31% of women (p = 0.036) and renal crisis developed in 17% of men versus 3% of women (p = 0.006). No significant differences regarding social history, smoking, medical history, or disease management were identified. After excluding non-SSc-related deaths, survival was worse in men (p = 0.005, Kaplan-Meier analysis) with significantly lower 6- and 12-year cumulative rates (77.2% and 53.8%, respectively, in men vs 97.3% and 89.2% in women). Conclusion Results derived from an unselected SSc population indicate that the disease is more severely expressed in men than in women, a finding that could be related to more rapid development of vasculopathy in men. Studies are warranted in other single-center cohorts to confirm these findings.