Abstract Objectives Previous studies have identified unique challenges for rheumatoid arthritis (RA) patients of different genders, which impact disease management. However, the association between disease activity and healthcare-seeking behaviours in male and female RA patients remains underexplored. This study aimed to investigate this association, with a specific focus on the gender-specific effects of follow-up intervals on disease control. Methods A nationwide survey (July-September 2023) across 330 rheumatology centres in China included 13 278 female (83.85%) and 2,557 male RA patients (16.15%) aged ≥18 years. Standardized questionnaires captured demographic and healthcare-seeking behaviours. Disease activity was assessed using the Clinical Disease Activity Index (CDAI). Results Females had younger disease onset (45.84 vs 51.03 years, p 0.001), longer disease duration (7.51 vs 5.64 years, p 0.001), higher low disease activity/clinical remission rates (22.61% vs 15.33%, p 0.001), and lower glucocorticoid use (39.5% vs 47.73%, p 0.001). Despite similar self-reported regular follow-up rates (84.73% vs 83.14%), both genders experienced suboptimal visit intervals (3 months: 61.30% vs 62.65%, p 0.001). Prolonged follow-up intervals were independently associated with poor disease control (CDAI 10) in the female subgroup, with longer intervals linked to higher odds of inadequate control at 6-month (OR = 1.22, 95%CI : 1.09–1.37, p 0.001) and 12-month intervals (OR = 1.43, 95%CI : 1.22–1.60, p 0.001). Regular monitoring reduced high disease activity risk across genders (OR = 0.64, 95%CI : 0.56–0.74, p 0.001). A generalized linear model showed no significant follow-up interval-gender interaction on disease activity (all p 0.20). Conclusion This large-scale study reveals gender-dimorphic patterns in RA progression and healthcare engagement. Females tended to exhibit better treatment response, with a more pronounced interval-dependent disease control trend. No significant interval-gender interaction confirms this is a descriptive trend, not a validated gender-specific difference. Our findings emphasize the need for strategies accounting for such gender-dimorphic trends to optimize care continuity and improve RA management.
Xu et al. (Thu,) studied this question.