PT  - JOURNAL ARTICLE
AU  - Trentin, Francesca
AU  - Signorini, Viola
AU  - Manca, Maria Laura
AU  - Cascarano, Giancarlo
AU  - Gualtieri, Luca
AU  - Schilirò, Davide
AU  - Valevich, Anastasiya
AU  - Cardelli, Chiara
AU  - Carli, Linda
AU  - Elefante, Elena
AU  - Ferro, Francesco
AU  - Stagnaro, Chiara
AU  - Zucchi, Dina
AU  - Tani, Chiara
AU  - Mosca, Marta
TI  - Gender differences in SLE: report from a cohort of 417 Caucasian patients
AID  - 10.1136/lupus-2022-000880
DP  - 2023 Apr 01
TA  - Lupus Science & Medicine
PG  - e000880
VI  - 10
IP  - 1
4099  - http://lupus.bmj.com/content/10/1/e000880.short
4100  - http://lupus.bmj.com/content/10/1/e000880.full
SO  - Lupus Sci Med2023 Apr 01; 10
AB  - Background SLE is an autoimmune disease that predominantly affects women. As most epidemiological and interventional studies are on populations with a clear female prevalence, the influence of gender in disease course, drug response and damage accrual is yet to be fully explored and comprehended.Objectives To describe gender differences in disease course, comorbidities, use of medications and long-term outcomes of a large cohort of patients with SLE.Methods Retrospective gender-based analysis of prospectively collected data from a monocentric cohort of Caucasian patients with SLE with at least 1 year of follow-up.Results 417 patients were included, 51 men and 366 women. Men displayed a significantly higher median age at disease onset and diagnosis and a higher prevalence of late-onset SLE, serositis at disease onset, antiphospholipid syndrome (APS) and use of mycophenolate within the first year of disease. Women had a higher prevalence of haematological abnormalities, a higher cumulative exposure to azathioprine and higher cumulative dose of glucocorticoids at 5 years. Male patients had a shorter time to first damage item and a higher prevalence of damage at 1 and 5 years, but this association was no longer significant when late-onset patients were excluded. No differences were found in prevalence of childhood onset, delay between onset and diagnosis, time to renal involvement and histology, cumulative autoantibody positivity, number of flares and hospitalisations, median SLE Damage Index score, type of damage, age and time to first cardiovascular event, chronic kidney disease and death.Conclusions In our cohort, clinical manifestations and disease course were similar in male and female patients; however, male patients displayed higher prevalence of APS and early damage accrual probably due to the later disease onset. These data highlight the importance of an intensive follow-up, prevention and treatment of complications in this category of patients, especially in the first years of disease.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, CT, upon reasonable request. The data are not publicly available due to their containing information that could compromise the privacy of research participants.