Sex Differences in Treatment Response in Axial Spondyloarthritis

<p>In this episode of <em>RheumaCast</em>, we explore new data from the international PROOF cohort on sex-specific differences in achieving disease control in axial spondyloarthritis (axSpA). The authors present compelling evidence that women with non-radiographic axSpA (nr-axSpA) are significantly less likely than men to reach low disease activity or inactive disease—despite similar treatment approaches and TNFi use.</p><p>What’s behind this disparity? We discuss potential contributors, including nociplastic pain mechanisms, mechanical mimics like osteitis condensans ilii, and sex-specific differences in sacroiliac joint anatomy. The findings highlight the urgent need for accurate diagnosis and a nuanced approach to treatment in women with axSpA—especially in the non-radiographic stage.</p><p>This episode is based on the publication: Poddubnyy D, et al. <em>Rheumatology</em> 2025; doi:10.1093/rheumatology/keaf447 and developed with NotebookLM.</p>