Understanding differences between men and women with axial spondyloarthritis

Grace C. Wright, Jeffrey Kaine, Atul Deodhar

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations


Axial spondyloarthritis (axSpA) is a chronic inflammatory immune-mediated disease resulting in inflammatory low back pain and other inflammatory manifestations in peripheral joints and entheses. AxSpA encompasses both ankylosing spondylitis (AS), in which patients present with definitive sacroiliitis visible on radiographic imaging, as well as nonradiographic axSpA (nr-axSpA), in which such changes may not be discernable. Emerging evidence suggests that women and men experience axSpA differently. Although the prevalence of AS is approximately 2- to 3- fold higher in men than in women, nr-axSpA occurs with roughly equal frequency in women and men. The goal of this review is to increase awareness of sex differences in axSpA by exploring the distinct manifestations of disease and disease characteristics in women, the overall clinical burden, recommendations for diagnosis, and potential treatment options. We summarize and contextualize the results of recent studies that illuminate sex differences in nr-axSpA and AS, including differences in disease manifestation and progression. It is important that sex differences in axSpA are understood and considered when diagnosing and treating the spectrum of axSpA, including AS and nr-axSpA.

Original languageEnglish (US)
Pages (from-to)687-694
Number of pages8
JournalSeminars in Arthritis and Rheumatism
Issue number4
StatePublished - Aug 2020


  • Ankylosing spondylitis
  • Nonradiographic axial spondyloarthritis
  • Sex
  • Sex differences
  • Spondyloarthritis
  • Women's health

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine


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