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Clinical Reviews in Allergy & Immunology

Published in:

01-06-2019

Sex and Management of Rheumatoid Arthritis

Authors: Ennio Giulio Favalli, Martina Biggioggero, Chiara Crotti, Andrea Becciolini, Maria Gabriella Raimondo, Pier Luigi Meroni

Published in: Clinical Reviews in Allergy & Immunology | Issue 3/2019

Abstract

Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease more common in women than men (3:1). Although sex-based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between sex and RA is still partially lacking. Furthermore, males and females have been demonstrated to differently deal with their chronic pathologies, modifying the perceived sex-based burden of disease. Gender medicine is a newly approach focusing on the impact of gender differences on human physiology, pathophysiology, and clinical features of diseases, analyzing the complex interrelation and integration of sex and psychological and cultural behavior. A better comprehension of possible factors influencing sexual dimorphism in RA susceptibility, pattern of presentation, disease activity, and outcome could contribute to a tailored approach, in order to limit the morbidity of the disease. RA disease activity seems to be higher in women, whereas the response rate to synthetic and biologic disease-modifying therapies appears to be better in males. Moreover, the common strategies for RA management may be affected by concomitant pregnancy or childbearing desire, with particular regard to treatments with potential teratogenic effects or impact on fertility. Finally, comorbidities, such as fibromyalgia, major depression, and osteoporosis, are more frequent in females, while the impact of sex on cardiovascular risk is still controversial. Moving from the role of sex in influencing RA pathogenesis, epidemiology, and disease characteristics, this review explores the evidence on how sex can have an impact on strategies for managing patients with RA.

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Title: Sex and Management of Rheumatoid Arthritis
Authors: Ennio Giulio Favalli
Martina Biggioggero
Chiara Crotti
Andrea Becciolini
Maria Gabriella Raimondo
Pier Luigi Meroni
Publication date: 01-06-2019
Publisher: Springer US
Published in: Clinical Reviews in Allergy & Immunology / Issue 3/2019
Print ISSN: 1080-0549
Electronic ISSN: 1559-0267
DOI: https://doi.org/10.1007/s12016-018-8672-5

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