In patients with psoriatic arthritis, women experience greater disease impact than men
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Among patients with similar psoriatic arthritis disease activity and therapy, women demonstrate higher levels of disease burden than men, according to data published in The Journal of Rheumatology.
“Sex may play an underlying role in driving the mechanisms of PsA, leading to different clinical manifestations of the disease,” Laure Gossec, MD, PhD, of the Pitie-Salpetriere Hospital, and Pierre and Marie Curie University, in Paris, and colleagues wrote. “Women with PsA may also experience greater disability and impact on their [quality of life (QoL)] than men."
“However, there is limited research available on these differences in a real-world setting,” they added.
To evaluate differences in disease burden among male and female patients with PsA, Gossec and colleagues conducted a cross-sectional survey of rheumatologists and dermatologists, as well as their patients, living in France, Italy, Spain, the United Kingdom and the United States. Data were derived from the Adelphi PsA Disease Specific Program, a point-in-time survey conducted between June 2018 and August 2018, intended to shed light on disease management and disease-related impact on clinical practice, according to the researchers.
Collected data included patient record forms filled out by the physician as well as self-reported questionnaires completed by the included patients. The record forms included data on patient demographics, clinical characteristics, medication usage and treatment history. Meanwhile, the patient survey included generic health status, disability status, work productivity status and disease impact status. Clinical markers, including the 68 tender joint count, 66 swollen joint count, body surface area impacted and Charlson Comorbidity Index Score, were calculated for every patient.
The analysis included a total of 2,270 patients, of whom 1,047 were women. According to the researchers, disease presentation, disease duration and biologic use were similar across men and women. However, women reported worse quality of life scores (P = .02), higher rates of disability (P < .01) and greater levels of work impairment (P < .01). Men reported a higher burden of comorbidities (P < .01).
“Despite women and men having similar levels of physician-assessed disease activity and receiving similar treatment regimens, women reported a reduced QoL and greater levels of disability and work impairment than men, while experiencing a lower comorbidity burden,” Gossec and colleagues wrote. “Further research is needed to explore the additional burden experienced by women with PsA, and whether alternative treatment regimens would alleviate some of these differences.”
Reference:
Eder L, et al. Int J Clin Rheumatol. 2012;doi:10.2217/IJR.12.63.
Perspective
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Gossec and colleagues discussed the differences in psoriatic arthritis between men and women, and their findings reflect what we see in our practice. Women have far more disease burden, including fatigue, pain, depression and anxiety. Since women are still the primary family caregivers, this impacts everyone’s quality of life. We know women will experience more side effects and will discontinue therapies early without any treatment targets being achieved.
We use combination therapy in other disease states and we need to explore more options for our patients that are struggling with PsA. Holistic options and non-pharmaceutical choices, in conjunction with our treat-to-target plans, need to be tested in the real world so we have something to offer this patient population.
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