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![\"\"](\"https:\/\/medizinonline.com\/wp-content\/uploads\/2021\/11\/rubbert-roth.jpg\")
\nClinic for Rheumatology
\nCantonal Hospital St. Gallen
\nSt. Gallen<\/p>\n
axSpA – “Adapting therapy for women”<\/strong><\/p>\n With axSpA, rheumatologist Dr. Diana Dan presented a disease in which diagnosis is severely delayed, especially in women. Thus, according to an analysis of 1677 axSpA patients, the already very long diagnostic latency of an average of 5.7 years is even higher in young, HLA-B27-negative women [2]. One reason is that axSpA often manifests atypically in women and in the nonradiographic (nr-axSpA) form with decreased inflammation. For example, in one study, women were twice as likely to be affected by nr-axSpA as men, and in another study, women showed significantly reduced signs of inflammation [3, 4]. These findings also have implications for treatment, for example, nr-axSpA patients with higher inflammatory parameters may respond better to therapies with TNF blockers according to study results [5]. Dr. Dan also explained that many patients are of childbearing age and treatment should be compatible with a desire to have children. This should be seen in particular against the background that many pregnancies are unplanned. “According to the ACR guidelines, among TNF inhibitors, we can only use certolizumab pegol before and during pregnancy and lactation,” she emphasized(Table<\/strong>) [6].<\/p>\n Diana Dan, MD<\/strong> Table: ACR recommendations for medications before and during pregnancy and during lactation (adapted from [6]).<\/strong><\/p>\n Severe osteoporosis – “Romosozumab is an effective and tolerable therapy”<\/strong><\/p>\n Osteoporosis is a disease that particularly affects postmenopausal women [7]. Since July 2020, the sclerostin inhibitor romosozumab has been available to these women for the treatment of severe osteoporosis with high fracture risk [8]. Internist PD Dr. Brigitte Uebelhart summarized that the positive results of the three main studies ARCH, STRUCTURE and FRAME suggest the preferred use of romosozumab over alendronate and teriparatide. In direct comparison with the established antiresorptive drug alendronate or with placebo, romosozumab significantly reduced the recurrence of vertebral fractures within one year with comparable tolerability and, compared with alendronate, also significantly reduced the risk of clinical fractures [9, 10]. In addition, romosozumab was shown to be superior to both alendronate and teriparatide in improving bone mineral density [9, 11]. “The 15 patients currently being treated with romosozumab at our HUG in Geneva show very good efficacy with good tolerability and high adherence,” Dr. Uebelhart concluded.<\/p>\n PD Brigitte Uebelhart, M.D. <\/strong> Conclusion<\/strong><\/p>\n axSpA and osteoporosis show large gender discrepancies [2, 7]. Thus, diagnosis is significantly delayed in female axSpA patients compared with male affected individuals, and clinical presentation and treatment response also differ [2-5]. In osteoporosis, the gender differences are most evident in prevalence, as this disease affects postmenopausal women with particular frequency [7]. In order to provide optimal care to all affected individuals, treating physicians should be aware of these differences [1]. Study data show that the TNF inhibitor certolizumab pegol (Cimzia\u00ae) and the sclerostin inhibitor romosozumab (Evenity\u00ae) can contribute to adequate care for both sexes [6, 9-11].<\/p>\n Source: Continuum of Care FOR HER: Focus on Axial Spondyloarthritis and Osteoporosis, Annual Congress of the Swiss Society of Rheumatology (SGR), Sept. 02, 2021.<\/p>\n Literature<\/strong><\/p>\n This article was created with the kind support of UCB Pharma AG.<\/p>\n CH-N-CZ-axSpA-2100026<\/p>\n
\n![\"\"](\"https:\/\/medizinonline.com\/wp-content\/uploads\/2021\/11\/dan.jpg\")
\nService de rhumatologie et Centre des maladies osseuses
\nCentre hospitalier universitaire vaudois (CHUV)
\nLausanne<\/p>\n![\"\"](\"https:\/\/medizinonline.com\/wp-content\/uploads\/2021\/11\/bildschirmfoto_2021-11-23_um_09.02.37.png\")
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\n![\"\"](\"https:\/\/medizinonline.com\/wp-content\/uploads\/2021\/11\/uebelhart.jpg\")
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\nService des maladies osseuses
\nH\u00f4pitaux Universitaires Gen\u00e8ve (HUG)
\nGeneva<\/p>\n