Men and women report different quality of life, pain levels with rheumatoid arthritis

Rheumatoid arthritis (RA) is often a more painful experience for women than it is for men, even though the visible symptoms are similar among the genders, according to a recent report.

In a press release, scientists from Karolinska Institutet in Stockholm recommended that physicians should take more account of these subjective differences when assessing the need for medication.

For unknown reasons, RA is roughly three times more common among women than men. Several studies also suggest that RA eventually impairs the quality of life of women with the disease more than of men. Again, the underlying reasons are unclear, but scientists speculate that the medicines used affect women and men differently, according to the press release.

In the recent study at Karolinska, investigators reported that men who undergo standard therapy for rheumatism respond significantly better than women having the same treatment, both objectively — such as in the degree of swelling in the joints — and subjectively in terms of their own experience of the disease.

“Purely objectively, the drug had a somewhat better effect on the men than on the women,” said Ronald van Vollenhoven, MD, PhD, who led the study. “But the greatest difference was of a subjective nature. The women in the study felt sicker even when their joints showed the same improvements.”

According to van Vollenhoven, it is important to take into account subjective differences when judging the severity of the disease. If physicians only consider the physical symptoms, some people with severe pain might be deprived of the most effective medicine, he said in the press release.

In a follow-up analysis, the researchers compared the degree of disease in men and women who received biological medicines, which are typically administered only to patients with RA who are considered seriously ill, according to van Vollenhoven. The study results showed that while women and men who had been put on a course of treatment had similar objective manifestations of the disease, the women said they were sicker than the men.

“Women and men have been treated on equal terms from the perspective of the doctors, but it’s possible that no one has been aware of the fact that the pain can be worse for women than for men,” van Vollenhoven said in the press release. “Since our objective is to reduce suffering, we should try to take more account of the subjective aspects of rheumatoid arthritis.”