Gender-Based Disparities and Delayed Diagnosis in Egyptian Patients with Axial Spondyloarthritis: A Cross-sectional Study.

Fayez, Ebtesam; Abulfadl, Essam; Elsaman, Ahmed; Elbakry, Toqa; Khalifa, Asmaa

doi:10.21608/smj.2025.383617.1574

Gender-Based Disparities and Delayed Diagnosis in Egyptian Patients with Axial Spondyloarthritis: A Cross-sectional Study.

Document Type : Original Article

Authors

¹ Department of Physical Medicine, Rheumatology and Rehabilitation- Faculty of Medicine- Sohag University

² Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Sohag University, Egypt

³ Department of Rheumatology and Rehabilitation, Faculty of Medicine, Sohag University.

10.21608/smj.2025.383617.1574

Abstract

Background: Axial Spondyloarthritis (axSpA), including Ankylosing Spondylitis and non-radiographic axSpA, presents diagnostic challenges, with significant delays in diagnosis and unmet treatment needs, particularly in Egypt. This study aims to address these gaps, focusing on the Egyptian context and highlighting the disparity in disease burden and management between genders.

Aim: To enhance awareness and understanding of axSpA in Egypt, with a focus on unmet needs, especially in delayed diagnosis and gender-specific disparities in disease management.

Methods: An observational, cross-sectional study was conducted at Sohag University Hospital, involving 100 axSpA patients. Patients were assessed using the Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), Visual Analogue Scale (VAS), and Katz ADL index. Data on demographics, clinical manifestations, radiological and laboratory findings, and treatment received were collected.

Results: The study included a predominantly male cohort (82%) with an average age of 33.18 years. Key findings include a high prevalence of inflammatory lower back pain, limited spinal involvement, and moderate disease activity as indicated by ASDAS and BASFI scores. Gender-specific analysis revealed no significant differences in clinical, radiological, and serological features between men and women. Treatment primarily involved NSAIDs, DMARDs, and physiotherapy.

Conclusion: This study underscores the need for improved awareness and understanding of axSpA, particularly in recognizing and managing the disease in women. It highlights the necessity of targeted education for healthcare providers, deeper investigation into gender differences in axSpA, and the importance of gender-specific clinical trials.

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