Inmune-mediated inflammatory rheumatic diseases in transgender people: A scoping review

• Published in: Seminars in arthritis and rheumatism Vol. 52; p. 151920
• Main Authors: Salgado, Eva, Romera-Baurés, Montserrat, Beltran-Catalan, Emma, Naredo, Esperanza, Carreira, Patricia E, Garcia-Vivar, Mariluz, Moreno-Muelas, Jose V, Boteanu, Alina, Calvo-Penades, Inma, Sellas-Fernandez, Agusti, Valero, Marta, Gomez-Reino, Juan J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2022
• Subjects: Female; Hormone replacement therapy; Humans; Immune mediated rheumatic disease; Inflammatory arthropathy; Lupus Erythematosus, Systemic; Male; Muskuloeskeletal disease; Rheumatic Diseases - drug therapy; Rheumatic Diseases - epidemiology; Rheumatic Fever; Transgender Persons; SSc; Immune mediated rheumatic disease; Transgender; HRT; SLE; anti-dsDNA; RA; Inflammatory arthropathy; ANA; Muskuloeskeletal disease; GAS; Hormone replacement therapy; IMIRD
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2021.10.004

In immune-mediated inflammatory rheumatic diseases (IMIRD), there are differences between cis-men and cis-women in epidemiology, clinical feature, therapeutic approach, treatment response, and prognosis. In transgender individuals, information concerning IMIRD is not substantial. The assessment of information concerning rheumatic diseases in transgenders is crucial because transgenders may undergo treatments with potential impacts on IMIRD. We aim to collect and discuss current knowledge on IMIRD in transgender individuals, determine the coverage of the literature, identify the knowledge gaps, and highlight opportunities for future research. We did a scoping review of publications collected through a systematic search of transgender patients with any IMIRD. Data sources were Medline, Embase, and Web of Knowledge. Synthesis of results and qualitative review of data information was collected in tables. A semi-quantification of the quality of the articles reporting clinical studies was performed. There were 11 transwoman, and 3 transmen cases of systemic lupus erythematosus (5 cases), skin lupus erythematosus (2), systemic sclerosis (4), anti-synthetase syndrome (1), rheumatoid arthritis (1) and ankylosing spondylitis (1). Eleven were de novo cases and three had prior history of IMIRD and developed a comorbidity after starting hormone replacement therapy. The clinical expression of the disease was variable. Two transwomen and one transman developed thrombotic events. The lupus skin lesions in one transman improved following testosterone treatment. No clinical studies were identified. Quality of publications was disparate. Although the number of cases is small, most cases of IMIRD occur in transwomen. The absence of solid data warrants caution in establishing recommendations regarding hormone replacement therapy in transgenders with IMIRD. There is an essential need for the consideration of cisgender and transgender particularities in future research on IMIRD [Display omitted] •Transgenders may undergo treatments with potential impacts on immune-mediated rheumatic diseases (IMRD).•Assessing immune-mediated rheumatic diseases in transgenders is crucial.•We conducted a scoping review to collect and discuss current knowledge on IMRD in transgender individuals, determine the coverage of the literature, and identify the knowledge gaps.•In the absence of solid data, establishing recommendations regarding hormone replacement therapy in transgenders is not feasible.•There is a need for the consideration of cisgender and transgender particularities in future research on IMRD.