OBJECTIVE: To assess gender differences in disease characteristics and treatment 
responses over time in a disease-modifying antirheumatic drug (DMARD)-naive 
seropositive early rheumatoid arthritis (RA) cohort.
METHODS: Patients with polyarticular disease who were DMARD-naive and had 
seropositive early RA (< 14 months) were recruited by the Western Consortium of 
Practicing Rheumatologists. Each patient was examined at study entry, after 6 
and 12 months, and yearly thereafter. Clinical and demographic data were 
collected. We investigated gender differences in baseline disease 
characteristics and treatment using chi-squared, Mann-Whitney U, and t tests. We 
used generalized estimating equations (GEE) models for repeated measures to 
examine whether the rate of change of specific disease outcomes during the first 
2 years after DMARD initiation was significantly influenced by gender.
RESULTS: At baseline, men (n = 67) and women (n = 225) had similar disease 
activity and radiographic damage; men, however, had significantly worse erosion, 
while women had worse joint space narrowing. Despite similar treatment, women 
had worse disease progression over the 2-year followup, as assessed by trends in 
Disease Activity Score 28/erythrocyte sedimentation rate (DAS28-ESR4), physician 
global scores, and tender joint counts. In the GEE model, gender was 
significantly associated with the rate of change of DAS28-ESR4 scores (p = 
0.009), although not independently associated with disease activity. 
Self-reported measures (Health Assessment Questionnaire-Disability Index, 
patient global scores, fatigue, pain) were worse among women at baseline and 
throughout the study period. Men were more likely to achieve remission.
CONCLUSION: At baseline, men and women had similar disease activity and joint 
damage. Responses to treatment over time were better among men in this 
prebiologic era; women had worse progression despite similar treatment.