Gender-specific differences in patients with psoriatic arthritis receiving ustekinumab or tumour necrosis factor inhibitor: real-world data

Van Kuijk, A. W.R. et al. (2023) Gender-specific differences in patients with psoriatic arthritis receiving ustekinumab or tumour necrosis factor inhibitor: real-world data. Rheumatology, 62(10), pp. 3382-3390. (doi: 10.1093/rheumatology/kead089) (PMID:36810788) (PMCID:PMC10547514)

Abstract

Objective: Investigate effects of gender on disease characteristics and treatment impact in patients with psoriatic arthritis (PsA). Methods: PsABio is a non-interventional European study in patients with PsA starting a biological disease-modifying anti-rheumatic drug (bDMARD; ustekinumab or tumour necrosis factor inhibitor [TNFi]). This post-hoc analysis compared persistence, disease activity, patient-reported outcomes and safety between male and female patients at baseline and 6 and 12 months of treatment. Results: At baseline, disease duration was 6.7 and 6.9 years for 512 females and 417 males respectively. Mean (95% CI) scores for females versus males were: clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA), 32.3 (30.3;34.2) versus 26.8 (24.8;28.9); Health Assessment Questionnaire-Disability Index (HAQ-DI), 1.3 (1.2;1.4) versus 0.93 (0.86;0.99); total Psoriatic Arthritis Impact of Disease-12 (PsAID-12) score, 6.0 (5.8;6.2) versus 5.1 (4.9;5.3), respectively. Improvements in scores were smaller in female than male patients. At 12 months, 175/303 (57.8%) female and 212/264 (80.3%) male patients achieved cDAPSA low disease activity, 96/285 (33.7%) and 137/247 (55.5%), achieved minimal disease activity (MDA), respectively. HAQ-DI scores were 0.85 (0.77;0.92) versus 0.50 (0.43;0.56), PsAID-12 scores 3.5 (3.3;3.8) versus 2.4 (2.2;2.6), respectively. Treatment persistence was lower in females than males (p = <0.001). Lack of effectiveness was the predominant reason to stop, irrespective of gender and bDMARD. Conclusions: Before starting bDMARDs, females had more severe disease than males and a lower percentage reached favourable disease states, with lower persistence of treatment after 12 months. A better understanding of the mechanisms underlying these differences may improve therapeutic management in females with PsA. Trial registration: ClinicalTrials.gov, https://clinicaltrials.gov, NCT02627768.

• Item Type: Articles
• Additional Information: This study was sponsored by Janssen.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Siebert, Professor Stefan
• Authors: Van Kuijk, A. W.R., Nurmohamed, M. T., Siebert, S., Bergmans, P., de Vlam, K., Gremese, E., Joven-Ibáñez, B., Korotaeva, T. V., Lavie, F., Sharaf, M., Noël, W., Theander, E., Smolen, J. S., Gossec, L., and van der Horst-Bruinsma, I. E.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Rheumatology
• Publisher: Oxford University Press
• ISSN: 1462-0324
• ISSN (Online): 1462-0332
• Published Online: 22 February 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Rheumatology 62(10):3382–3390
• Publisher Policy: Reproduced under a Creative Commons License