Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New study reveals gender disparity in anti-TNF treatment for rheumatoid arthritis

18.06.2007
Subjective disease aspects 'discounted' in treatment decisions

Findings reported today at EULAR 2007, the Annual European Congress of Rheumatology (EULAR) in Barcelona, Spain, reveal a treatment disparity between female and male patients with rheumatoid arthritis (RA). Data from a study at the Karolinska Institute, Sweden, show that women receive anti-TNFs (very effective but expensive modern medications against this disease) at a higher perceived level of disease activity and when they are reporting more severe pain than their male counterparts.

Whilst some disease activity measurements were found to be higher for women than men, and self-reported disease activity by the patients themselves echoed this, the physicians’ global assessments showed little difference between the level of disease in the men and women of the study group.

Lead researcher Dr Ronald van Vollenhoven comments, “Women are known to have consistently worse long-term outcomes in rheumatoid arthritis than men. To date, it has been unclear if this is due to factors intrinsic to the disease or because of gender-related prescribing. Our study does not show a gender-bias as such, but does indicate that physicians to some extent ‘discount’ the subjective measures of disease activity, which we found to be higher in women, and let their decisions be driven almost solely by objective markers of the disease. As a result, women are receiving anti-TNFs at a higher level of disease symptoms than men. Because the goal of any treatment for RA must be to relieve the patients suffering, it is not clear that this approach is the right one.”

The study analysed baseline variables for the patients on RA who were started on anti-TNF treatment in the STURE Registry (the Stockholm TNF-alpha follow-up registry). When anti-TNFs were first prescribed to the 644 study participants, the level of their RA severity was logged, as measured according to Disease Activity Scale 28 (DAS28) which takes into account the severity of disease across the 28 joints most commonly affected by RA.

Each participant’s Erythrocyte Sedimentation Rate (ESR), which measures the level of inflammation, was also noted along with their Swollen Joint Count (SJC) and Tender Joint Count (TJC). Furthermore, both patients and their physicians completed a global assessment of disease activity, pain and physical activity (5 point scale questionnaire).

DAS28 scores at initiation of anti-TNF treatment were found to be significantly higher for women than for men (DAS28 was 5.53 for women, 5.04 for men, p=0.0006) and women had higher Tender Joint Counts (9.62 compared to 8.41 for males, p=0.066). The women in the study also had significantly higher ESR scores, although the authors suggest that this could be explained in part by the female hormone oestrogen, which affects tends to raise the ESR.

With regard to the more subjective self-reporting on the disease, through the patient-completed global health ratings, women also reported significantly worse global health (as measured by VAS and HAQ-disability index). However, the physician-completed global health ratings were equivalent for men and women.

Dr Ronald van Vollenhoven comments, “This study shows the importance of taking into account both objective and subjective measurement scores in treatment decisions. It is our hope that these data will help redress this imbalance and ensure equal prescribing and disease management for all.”

Rory Berrie | EurekAlert!
Further information:
http://www.eular.org

More articles from Health and Medicine:

nachricht Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center

nachricht Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: The pyrenoid is a carbon-fixing liquid droplet

Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.

A warming planet

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Rainbow colors reveal cell history: Uncovering β-cell heterogeneity

22.09.2017 | Life Sciences

Penn first in world to treat patient with new radiation technology

22.09.2017 | Medical Engineering

Calculating quietness

22.09.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>