SynthesisBMC rheumatology2025
Understanding sex-related differences among Asian axial spondyloarthritis patients: a systematic review and meta-analysis : Sex differences and clinical outcomes in Asian axial spondyloarthritis.
Synthesis in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAxial spondyloarthritis (axSpA) exhibits notable sex-related differences, particularly in Asian populations, influenced by genetic, cultural, and healthcare factors. This systematic review and meta-analysis assess sex-specific disparities in axSpA among Asian patients.
methodsA systematic search in PubMed, Embase, and Google Scholar (up to January 30, 2025) included studies reporting sex-specific differences in clinical presentation, diagnostic delay, treatment response, and quality of life. The study included 31,523 males and 10,815 females. Risk of bias was assessed using the ROBINS-I tool. Meta-analysis was performed using R and Jamovi, with heterogeneity assessed via I
resultsThirty studies comprising 31,523 male and 10,815 female axSpA patients were included. Males had an younger age of onset and diagnosis (MD: -3.48 years; 95% CI: -4.78 to -2.17; -3.57 years; 95% CI: -5.25 to -1.89). No significant differences in diagnostic delay were observed. (MD: -0.62 years; 95% CI: -1.55 to 0.32; p = 0.0551). Females exhibited higher disease activity scores (BASDAI MD: -0.57; 95% CI: -0.86 to -0.27; p = 0.00211) and inflammatory markers (ESR MD: -3.99 mm/h; p = 0.0476), whereas males showed greater radiographic progression (BASRI MD: 2.60; 95% CI: 1.86-3.34; p < 0.001). HLA-B27 positivity was higher in males (79.5% vs. 69.2%). Treatment adherence was lower in females. DISCUSSION: This study highlights critical sex-based disparities in axSpA among Asian populations, particularly regarding disease onset, progression, and treatment response. The findings emphasize the need for sex-specific diagnostic and therapeutic strategies to improve patient outcomes. REGISTRATION: The review protocol was registered on PROSPERO (CRD42025637163).
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