{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:42:52Z","timestamp":1789587772760,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006978","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006978","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to determine sex differences in disease outcomes in recent axial spondyloarthritis (SpA) over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the first 6\u2009years of follow\u2010up of the prospective French multicenter DESIR cohort. Patients analyzed had &lt;3\u2009years of disease, were naive to disease\u2010modifying antirheumatic drugs, and fulfilled the Assessment of SpondyloArthritis international Society classification criteria for axial SpA. Disease activity (Ankylosing Spondylitis Disease Activity Score [ASDAS] using the C\u2010reactive protein [CRP] level), patient global assessment (PtGA), CRP level, and radiographic sacroiliitis were compared between men and women (self\u2010reported sex) by linear and logistic mixed\u2010effects models.\u00a0Models were created for trajectories of disease activity over 6\u2009years in men and women, using k\u2010means.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 494 patients analyzed (mean\u2009\u00b1\u2009SD age 31.9\u2009\u00b1\u20097.5\u2009years, symptoms duration 20.7\u2009\u00b1\u200911.7 months), 50.4% were men. Over 6\u2009years of follow\u2010up, both men and women showed clear improvements in ASDAS\u2010CRP, PtGA, and CRP level. Women had higher ASDAS\u2010CRP and PtGA over time compared to men (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) with overall similar CRP levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.089), whereas structural damage increased more in men (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). One\u2010third of both men (33%) and women (34%) belonged to persistent high\/very high disease activity trajectories, but ASDAS\u2010CRP was globally higher in women in these trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In early axial SpA, clinical outcomes (disease activity and symptoms) were worse in women than men over 6\u2009years of follow\u2010up, whereas CRP was similar and structural damage was more frequent in men. Although similarly distributed, disease activity scores were higher in women in high\/very high disease activity trajectories. Sex appears to be an important contextual factor in axial SpA.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25103-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25103","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T03:10:38Z","timestamp":1676344238000},"page":"2107-2116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Influence of Sex on Early Axial Spondyloarthritis: A <scp>Six\u2010Year<\/scp> Longitudinal Analysis From a Large National Cohort"],"prefix":"10.1002","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8708-9324","authenticated-orcid":false,"given":"Krystel","family":"Aouad","sequence":"first","affiliation":[{"name":"INSERM UMRS 1136\u20106, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique, Sorbonne Universit\u00e9, Paris, France, and Saint George Hospital University Medical Center Saint George University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5025-0214","authenticated-orcid":false,"given":"Anne","family":"Tournadre","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Clermont Auvergne, CHU Clermont\u2010Ferrand, INRAE, UNH UMR 1019  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Lucasson","sequence":"additional","affiliation":[{"name":"INSERM UMRS 1136\u20106, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4687-5780","authenticated-orcid":false,"given":"Daniel","family":"Wendling","sequence":"additional","affiliation":[{"name":"CHRU de Besan\u00e7on, University Teaching Hospital, and EA 4266 EPILAB Universit\u00e9 Bourgogne Franche\u2010Comt\u00e9  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Cochin Hospital AP\u2010HP and INSERM U1153, Sorbonne Paris Cit\u00e9 Research Center Paris University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Fautrel","sequence":"additional","affiliation":[{"name":"INSERM UMRS 1136\u20106, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique and Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital AP\u2010HP, Sorbonne Universit\u00e9  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