POS1354 GENDER DIFFERENCES IN CLINICAL FEATURES AND BURDEN IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER: PRELIMINARY REPORT
Authors: M. T. Duruöz, A. Ozer, H. H. Gezer, M. Alkan Melikoglu, S. Hizmetli, H. S. Baklacioglu, N. Sahin, N. Öz, D. Erdem Gürsoy, D. Altintaş, P. Oba, S. Acer Kasman
Journal: Annals of the Rheumatic Diseases (2021)

Background: Familial Mediterranean fever (FMF) is the most common hereditary auto-inflammatory disease, which is more common in groups in the Mediterranean basin, characterized by recurrent attacks of febrile peritonitis, pleuritis and arthritis. Objectives: The aim of this study is to investigate the gender differences in clinical and demographic features in patients with familial Mediterranean fever (FMF). Methods: Patients with FMF diagnosed according to Tel-Hashomer criteria were included in this multi-center study. Data about age, sex, disease duration, symptom duration, age at diagnosis, comorbid diseases and medications were noted. All patients were screen with Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaires (HAQ), Short Form 36 (SF-36). The severity of FMF was assessed by the PRASS scoring system. Results: Of the 286 patients, 199 (69,6%) were female with the mean age 36,2(SD:12.32) years and 87 (30,4%) were male with the mean age 32,9(SD:12,6) years (p=0,017). Age of diagnosis in male patients was lower than in females (p=0,008). The most common genetic mutation in both genders was M694V gene mutation. Homozygous M694V positivity was higher in males (31,79% vs 17,4%). More than 90% of patients were receiving colchicine,10 (3,5%) patients were receiving anakinra and 5(1,75%) patients were receiving canakinumab. Among the patients regularly taking colchicine, 86.2% were females and 86% were males (p=0,981). There were no differences between male and females in terms of clinical findings, frequency and duration of attacks, presence of colchicine resistance, and the presence of amyloidosis (p&gt;0.05). ESR was detected higher in female group (p=0,011). Headache (p=0,001), migraine (p=0,031), and concomitant diseases (p=0,017) were also more common in females than males. Anxiety and depression scores were higher in females (p&lt;0,05). The PRASS activity scores were similar between genders (p&gt;0,05). All parameters of SF-36 were higher in male patients, while HAQ score was higher in females (p&lt;0,05). Conclusion: Although clinical findings, disease severity and treatment compliance are similar in both genders, males are diagnosed with FMF earlier than females, but findings such as anxiety, depression, migraine, and headache are more common in female patients. References: [1]Doğan HO, Koca Y, Erden G, Karaaslan Y, Bozat H. Evaluating MEFV mutation frequency in Turkish familial Mediterranean fever suspected patients and gender correlation: a retrospective study. Mol Biol Rep. 2012 May;39(5):6193-6. Table 1. Demographic and clinical features between female and male FMF patients. Female (n:199 ) Male (n:87 ) P Demographic features, mean (SD ) Age 36,2 (12.32) 32,9 (12,6) 0,017 BMI 26,87(5,73) 25,79(5,28) 0,177 Educational level, years 8,77(4,36) 12,08(3,23) 0,000 Age at diagnosis 28 (13,31) 23,7 (13,42) 0,008 Age at onset of disease 19,2 (12,6) 17 (10,6) 0,265 Clinical features, n (% ) Fever 166 (83,4) 77 (88,5) 0,268 Abdominal pain 180 (90,5) 78 (89,7) 0,835 Chest pain 62 (31,2) 20 (23) 0,160 Erysipelas like erythema 12 (6) 4 (4) 0,628 Arthritis 46 (23,1) 24 (24) 0,419 Arthralgia 102 (51,3) 42 (48,3) 0,643 Myalgia 101 (50,8) 47 (54) 0,611 MEVF mutations, n (% ) M694V/M694V 24 (12.3) 19 (22) 0.047 M694V h eterozygous 38 (19,5) 14 (16,3) 0.523 M694V/any 25 (12,8) 15 (17,4) 0.307 PRASS disease severity, n (% ) 0,813 Mild 99(49,7) 46(52,9) Moderate 88(44,2) 35(40,2) Severe 12(6) 6(6,9) ESR, mm/hour, mean (SD ) 23,77(16,27) 18,25(18,41) 0,011 HAQ, mean (SD ) 0,49 (0,63) 0,16 (0,43) 0,000 HAD, mean (SD ) Anxiety 8,4 (4,4) 6,7 (3,44) 0,003 Depression 7,1 (4,27) 5,7 (3,81) 0,006 SF-36, mean (SD ) Physical functioning 63,56 (23,81) 79,93 (19,32) 0,000 Physical role limitation 45,78 (40,95) 61,41 (39,14) 0,003 Emotional role limitation 47,36 (42,04) 66,20 (40,69) 0,020 Energy/fatigue 42,50 (20,64) 53,64 (19,82) 0,000 Emotional well-being 51,61 (18,47) 58,74 (18,30) 0,003 Social functioning 57,06 (23,09) 70,52 (23,82) 0,000 Pain 51,66 (24,05) 65,72 (24,51) 0,000 General health 39,53 (20,01) 52,46 (23,83) 0,000 Disclosure of Interests: None declared