Background:Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the synovial tissue and destruction of the underlying cartilage and bones. It was found that RA more often affects women than men, with a sex ratio of 3: 1. And the question of the influence of gender on the outcomes and course of RA remains controversial, there is no consensus on whether RA is worse in women or men. Recent reports indicate that women are less likely to achieve remission than men. Women suffer from RA at an earlier age and have higher markers of disease activity such as DAS28 and HAQ. Rituximab is a chimeric monoclonal antibody that targets the CD20 molecule expressed on the surface of B cells, it has been successfully and widely used for the treatment of rheumatoid arthritis, so it is of interest to assess whether gender influences the therapeutic and radiological effects of RTX.Objectives:The aim of this study was to analyze the impact of gender on the response to rituximab (RTX) in patients with RA.Methods:Initially, 221 women(w), 27 men(m), were examined to assess the clinical and X-ray effect (88w/6m), who received RTX treatment (1000 mgx2 or 500 mgx2). Both groups were comparable in terms of the main clinical and laboratory characteristics (age, duration of the disease, the number of preceding DMARDs, in both groups most patients were RF + and ACCP +, a high degree of activity according to DAS 8 - men - 5.6 [4.6-6.7], women - 6.04 [5.2-6.63] Initially, the degree of radiological changes in men is slightly higher than in women (p> 0.05). Clinical effect was scored by EULAR criteria, radiographic progression was assessed using Sharp/van der Heijde modified scoring method.Results:When assessing the clinical effect after 48 weeks in men, a significantly better effect of RTX treatment was noted in comparison with women (Δ DAS28, a significantly better effect was noted in men - Δ DAS28 =3.75[2.8-4.14], and Δ DAS28=1.3[0.37-2.72] in women, (p=0.04). Analyzing the X-ray effect after 48 weeks of RTM treatment: the absence of progression in terms of the total score in 83.33% of men and 60.98% of women; there was no progression in narrowing of the joint space in 83.33% of men and 65.85% of women, noteworthy that the account of erosion practically reaches statistical significance - inhibition of destruction in 100% of men and 74.31% of women (p = 0.06).Conclusion:Thus, having analyzed the clinical and antidestructive effects of RTM therapy depending on gender, we can conclude that the effect is significantly higher in the male group. Also, there is a tendency towards more effective inhibition of radiographic progression in men.Disclosure of Interests:None declared
Radiographic remission in rheumatoid arthritis quantified by computer-aided joint space analysis (CASJA): a post hoc analysis of the RAPID 1 trial
