Decrease its pain in prolonged spondyloarthritis favour male patients

A questionnaire with 78 items relating to the state of health and situation of patients suffering from ankylosing spondylitis (AS) was sent to a representative sample (3,000) of more than 14,000 members of the German AS patients society ("Deutsche Vereinigung Morbus Bechterew"). 1,614 patients (54%) responded. 34% of the responding patients were female. 28% of the patients responding to the survey are not suffering from idiopathic AS but from psoriatic spondyloarthritis (Ps-S) or spondyloarthritis combined with inflammatory bowel disease (IBD-S). For the entire sample, distribution of the degree of pain does not depend on the duration since occurrence of the first spondylitis symptoms. If, however, male and female patients are considered separately, a significant decrease in the frequency of severe pain is seen after the disease has persisted for 30 to 40 years both in male AS patients and in male Ps-S or IBD-S patients (from 29% on the average of the first 3 decades to 20% for longer duration of the disease in AS, to 0% after the 4th decade of disease in Ps-S or IBD-S). In female patients, on the other hand, the frequency of severe pain increases continually from 28% in the average of the first 3 decades to 46% after the 4th decade. It seems that the slower and less complete ankylosis in female spondyloarthritis patients impedes a similar decrease in pair as observed in male spondyloarthritis patients. Frequency of complete painlessness increases in male spondyloarthritis patients to 14% after the 4th decade of disease whereas in female patients it is approximately 5% independent of disease duration. The dependence of anti-inflammatory drug therapy on disease duration shows a similar pattern. The frequency of severe difficulty in performing everyday functions decreases only in male Ps-S and IBD-S patients after a long duration of the disease while remaining almost unchanged in male AS patients and increasing continually in female AS patients. The number of female Ps-S and IBD-S patients was not sufficient for a definite longterm assessment.