Non-radiographic axial spondyloarthritis (nr-axSpA): A disproportionate issue for women

While ankylosing spondylosis (AS) affects men:women in a 2:1 ratio, the opposite is true for nr-axSpA, where up to two-thirds of patients are women.1

nr-axSpA disproportionately affects women.1

In general, axSpA is identified later in women than in men. This may be because women have less severe or slower progression of radiographic damage, even after years of symptoms.1,2

Despite no visible damage on x-ray, nr-axSpA has a comparable symptom burden to AS.3

Furthermore, symptoms may overlap with those of fibromyalgia, another syndrome that affects more women than men. This can also contribute to diagnostic delays for women with axSpA.4,5

axSpA presents differently in women vs men

Women and men with axSpA may present with different symptom clusters, with women demonstrating more peripheral pain than men.*6

Image of female and male skeletons, labelled with pain points

*Study participants were diagnosed with AS.6


AS, ankylosing spondylitis; axSpA, axial spondyloarthritis; nr-axSpA, non-radiographic axial spondyloarthritis.


  1. Boonen A, et al. Semin Arth Rheum. 2015;44(5):556–562.
  2. Rusman T, et al. Curr Rheumatol Rep. 2018;20(6):35.
  3. Mease PJ, et al. Arthritis Care Res (Hoboken). 2018;70(11):1661–1670.
  4. Chakrabarty S & Zoorob R. Am Fam Physician. 2007;76(2):247–254.
  5. Baraliakos X, et al. Rheumatology (Oxford). 2018;57(9):1541–1547.
  6. Lee W, et al. Ann Rheum Dis. 2007;66(5):633-638.
Rate this content: 
No votes yet
UK | April 2021 | 114846

Ask Speakers


Medical Information Request

Adverse events should be reported. Reporting forms and information can be found at Adverse events should also be reported to Novartis via [email protected] or online through the pharmacovigilance intake (PVI) tool at
If you have a question about the product, please contact Medical Information on 01276 698370 or by email at [email protected]