Characteristics and outcomes of male participants in the Australian Scleroderma Cohort Study (ASCS).

Abstract

OBJECTIVE: To determine the differences in demographic, serologic and clinical characteristics between male and female patients with systemic sclerosis (SSc) in an Australian cohort. METHOD(S): Retrospective observational study using data from the Australian Scleroderma Cohort Study (ASCS). Males (M) were compared to females (F) using chi-squared, Wilcoxon rank-sum and student's t-tests. Survival analysis from time of diagnosis to all-cause mortality was presented on Kaplan-Meier curves and a multivariate Cox proportional hazards model was used to evaluate independent predictors of all-cause mortality. A sub analysis of patients with incident SSc, defined as disease duration less than four years from onset of first non-Raynaud's manifestation to recruitment, was performed. RESULT(S): Of 2,033 participants, 299 were male with a F:M ratio of 5.8:1. Males were more likely to present with diffuse skin involvement (43.7%vs23.6%,p<0.001) and ever be positive for digital ulcers, digital pitting, gangrene and tendon friction rubs as well as myositis and interstitial lung disease. Males were more likely to have anti-Scl-70, anti-Jo-1, anti-PM/Scl and anti-RNA-polymerase III antibodies compared to females. Males reported more exposure to silica dust, organic solvents, vinyl chloride and epoxy resin compared with females. In the incident cohort, males had statistically significantly higher mortality with 60% of males compared to 82% of females surviving ten years from diagnosis (p<0.001). CONCLUSION(S): Males with SSc have more extractable nuclear antigen antibody positivity and reduced survival in comparison to females. The significant difference between occupational exposures recorded between sexes warrants further investigation into the role of industrial exposures in the pathogenesis of SSc in males.Copyright This article is protected by copyright. All rights reserved.