Systemic sclerosis (SSc), also known as scleroderma, is a complex autoimmune disease that affects the skin and various organs in the body. It causes the body’s immune system to mistakenly attack healthy tissues, leading to inflammation and thickening of the skin. Over time, this leads to the skin becoming hard and tight, making it difficult to move and causing pain. SSc can also affect internal organs, leading to various complications. In addition, there are notable differences in how systemic sclerosis affects men and women. The exact cause of SSc is not known; however, understanding gender differences is important for tailoring treatment and improving outcomes for patients, because there is no cure. Systemic sclerosis presents a public health challenge due to low awareness, and delayed diagnosis. SSc is also an economic burden because the disease limits a person’s ability to work and can lead to disability.
According to GlobalData’s forecast in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan), SSc is more common in women than men in 2023 (Figure 1, above). More than 80% of diagnosed prevalent cases in each of the 7MM presented in women in 2023. The diagnosed prevalent cases in women in the combined 7MM were approximately five times higher than that of men. This suggests that certain factors related to being female—such as hormones like estrogen, which is higher in women—might activate certain immune cells, leading to inflammation and fibrosis. Although SSc is more prevalent in women than men, studies have shown that men tend to have higher mortality rates as they present with a more severe and aggressive form of the disease, particularly concerning internal organ involvement. For example, women are more likely to present with limited cutaneous systemic sclerosis (lcSSc), characterized by skin thickening affecting the hands, face, and forearms. In contrast, men are more likely to develop diffuse cutaneous systemic sclerosis (dcSSc), which involves widespread skin thickening and internal organ damage. GlobalData estimates that approximately 70% of diagnosed prevalent cases of SSc were lcSSc in the combined 7MM.
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Other gender differences are seen in the timing of diagnosis. Men tend to be diagnosed at a later stage compared to women. This delay can lead to late treatment and increase the risk of disease progression, leading to poorer outcomes. By understanding these gender differences, healthcare professionals can tailor treatments and improve outcomes for patients. Increased awareness is important, as SSc is often misdiagnosed in its early stages. Furthermore, with the increasing ageing population worldwide, the number of prevalent cases of SSc is expected to rise, making a better understanding of the disease aetiology imperative.
