Gender-Specific Characteristics of Rheumatoid Arthritis

Background: In the past decade, gender-specific issues of rheumatoid arthritis (RA) have attracted increasing attention. While the predominance of women and their earlier disease onset is widely accepted, different phenotypes between sexes and alterations of RA depending on age at clinical manifestation are intensely discussed. Material and Methods: In this article data from the National Database of the German Collaborative Arthritis Centres (Kerndokumentation) and the current literature are evaluated. Results: Women with RA suffer from more severe disease, based on pain, disease activity and a concomitant fibromyalgia syndrome also comprising fatigue. Compared to men with RA the major difference is a more limited functional capacity in women. This difference seems to increase with disease duration. There are inconsistent data regarding radiological progression, so this question remains unsolved. There is no doubt that men reach remission faster than women. Conclusion: Reasons for these differences are subjects of discussion. Hormonal disparities and differing body composition seem to play an equal role as does variation in behaviour between genders. There is an obvious need for more studies on these issues - providing the opportunity to develop different treatment regimens for men and women.