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Aktuelle Rheumatologie 2011; 36(06): 352-360
DOI: 10.1055/s-0031-1287800
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Geschlechtsspezifische Aspekte der Rheumatoiden Arthritis

Gender-Specific Characteristics of Rheumatoid Arthritis
D. Huscher
1   Deutsches Rheuma-Forschungszentrum Berlin, Epidemiologie, Berlin
,
C. Sengler
1   Deutsches Rheuma-Forschungszentrum Berlin, Epidemiologie, Berlin
,
K. Thiele
1   Deutsches Rheuma-Forschungszentrum Berlin, Epidemiologie, Berlin
,
S. Bischoff
1   Deutsches Rheuma-Forschungszentrum Berlin, Epidemiologie, Berlin
,
A. Pfäfflin
1   Deutsches Rheuma-Forschungszentrum Berlin, Epidemiologie, Berlin
,
E. Gromnica-Ihle
2   Internistin/Rheumatologin, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
14 October 2011 (online)

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Zusammenfassung

Hintergrund:

In den letzten Jahren haben geschlechtsspezifische Aspekte bei der Rheumatoiden Arthritis (RA) zunehmende Beachtung gefunden. Während die Dominanz der Frauen und der frühere Erkrankungsbeginn bei ihnen unumstritten sind, werden sowohl der unterschiedliche Phänotyp der RA bei den Geschlechtern sowie auch Veränderungen der RA in Abhängigkeit vom Manifestationsalter heftig diskutiert.

Material und Methoden:

Neben den aktuellen Daten aus der Rheumatologischen Kerndokumentation der Regionalen Kooperativen Rheumazentren wird die wesentliche aktuelle Literatur zu dieser Thematik ausgewertet.

Ergebnisse:

Dabei zeigt sich, dass Frauen mit RA eine deutlich größere Krankheitslast aufweisen, gemessen mit der Schmerzangabe, der Krankheitsaktivität und einer begleitenden Fibromyalgie-Symptomatik einschließlich Fatigue. Der größte Unterschied zu den Männern mit RA besteht im schlechteren Funktionsstatus der Frauen. Diese Differenz scheint sich im Krankheitsverlauf der RA noch weiter zu vergrößern. Zur radiologischen Progression liegen unterschiedliche Daten vor, diese Frage bleibt offen. Unbestritten ist, dass Männer schneller eine Remission der RA erreichen als Frauen.

Schlussfolgerung:

Die Gründe für diese Differenzen werden diskutiert. Hormonelle Unterschiede und unterschiedlicher Körperbau scheinen eine ebenso wichtige Rolle zu spielen wie Unterschiede in der Verhaltensweise zwischen Männern und Frauen. Weitere Studien zu diesen Fragen sind dringend notwendig. Es könnten sich daraus unterschiedliche Therapiestrategien für Männer und Frauen entwickeln.

Abstract

Background:

In the past decade, gender-specific issues of rheumatoid arthritis (RA) have attracted increasing attention. While the predominance of women and their earlier disease onset is widely accepted, different phenotypes between sexes and alterations of RA depending on age at clinical manifestation are intensely discussed.

Material and Methods:

In this article data from the National Database of the German Collabora­tive Arthritis Centres (Kerndokumentation) and the current literature are evaluated.

Results:

Women with RA suffer from more severe disease, based on pain, disease activity and a concomitant fibromyalgia syndrome also comprising fatigue. Compared to men with RA the major difference is a more limited functional capacity in women. This difference seems to in­crease with disease duration. There are inconsistent data regarding radiological progression, so this question remains unsolved. There is no doubt that men reach remission faster than women.

Conclusion:

Reasons for these differences are subjects of discussion. Hormonal disparities and differing body composition seem to play an equal role as does variation in behaviour between genders. There is an obvious need for more studies on these issues – providing the opportunity to develop different treatment regimens for men and women.

Schlüsselwörter

rheumatoide Arthritis - Geschlecht - Schmerz - Krankheitsaktivität - Funktionsstatus

Key words

rheumatoid arthritis - gender - pain - disease activity - functional capacity
 

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