A NEW study highlights striking sex-related differences in the pulmonary involvement of patients with systemic sclerosis (SSc), shedding light on how men and women experience distinct respiratory complications in this complex autoimmune disease.
The retrospective study analysed 393 patients diagnosed with SSc, focusing on the presence of interstitial lung disease (ILD) and small airway disease (SAD). Key findings revealed that male patients exhibited a higher prevalence of ILD and were diagnosed with the condition sooner than their female counterparts. However, women were more prone to SAD, with significantly lower maximal-mid expiratory flow rates (MMEF) and a higher residual volume-to-total lung capacity ratio, indicative of impaired small airway function.
In addition to pulmonary differences, the study noted sex-related variations in other disease manifestations. Men were more likely to present with electrocardiogram abnormalities, while women experienced longer delays in diagnosis following Raynaud’s onset and had higher rates of telangiectasias, calcinosis, and arthralgias. Importantly, multivariate analysis confirmed female sex as an independent predictor of SAD, further emphasising the unique impact of sex on disease progression.
The findings underscore the need for tailored approaches in the management of SSc, taking into account the distinct pulmonary complications experienced by men and women. Early identification and intervention for ILD in men and SAD in women could lead to better outcomes and personalised care strategies.
Reference
Koletsos N et al. Pulmonary involvement in systemic sclerosis: can sex play a role? Rheumatol. 2024;DOI: 10.1093/rheumatology/keae639.
