There are important sex differences in pain scores in inflammatory arthritis. Pain levels are higher in female patients. In spondyloarthritis, female patients have more peripheral arthritis and less frequent spinal involvement than male patients.
Barnabe and associates conducted a study using PubMed and Embase as data sources, along with manual searches of reference lists and conference abstracts. Included were cohort studies and randomized trials that compared pain scores, treatment effectiveness in reducing pain, or pain localization between female and male patients with rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis, or reactive arthritis.
In a meta-analysis of mean visual analog scale (VAS) scores (0 to 10) in 16 RA cohort studies, the standardized mean difference in VAS scores was 0.21. Disease-modifying therapy resulted in improvement in mean scores for both sexes, but absolute scores in female patients remained higher. In 12 spondyloarthropathy cohorts that reported pain localization, more peripheral arthritis and less inflammatory back pain developed in female patients than in male patients during their disease course (68.9% vs 51.2% and 50.6% vs 66.4%, respectively).
The authors noted that these differences may affect a clinician's perception of disease severity and activity and thus influence management decisions.