Real-World Study Finds Gender Differences in Psoriatic Arthritis

By Rebecca Araujo - Last Updated: February 13, 2023

According to a survey of patients with psoriatic arthritis, women experience a higher disease burden compared with men. These findings were published in the Journal of Rheumatology.

Impact of Psoriatic Arthritis

Psoriatic arthritis is a chronic inflammatory musculoskeletal disease that is associated with skin and nail psoriasis, peripheral arthritis with joint pain, spinal involvement, enthesitis, dactylitis, and fatigue. The disease is known to present at similar rates in men and women; however, the authors of the study in the Journal of Rheumatology sought to clarify whether patient sex was associated with differences in clinical manifestations and quality of life for individuals with this disease.

The investigators conducted a cross-sectional survey of both patients with psoriatic arthritis as well as their rheumatologists/dermatologists. The survey was conducted in the US and France, Germany, Italy, Spain, and the UK between June and August 2018. Data collection included: demographics, treatment use, clinical characteristics, the EuroQoL 5-Dimension questionnaire (EQ-5D), the Psoriatic Arthritis Impact of Disease (PsAID12), the Health Assessment Questionnaire–Disability Index (HAQ-DI), and the Work Productivity and Impairment Index (WPAI). Outcomes and data were compared between men and women.

Overall, 2,270 patients completed the survey. The mean age was 48.6 years, with a mean disease duration of 4.9 years. Forty-six percent (N = 1,047) were women.

Psoriatic Arthritis in Women

The results showed that disease duration and presentation were comparable between sexes. Biologic use was also similar overall, with a mean usage rate of 54.2%.

However, women had significantly greater disability than men, with a mean HAQ-DI of 0.56 compared with 0.41, respectively (P<.01). EQ-5D scores were also significantly lower in women than in men (0.80 vs. 0.2; P=.02), as well as work impairment (WPAI: 27.9% vs. 24.6%; P<.01). Notably, women had a lower comorbidity burden than men, measured via the Charlson Comorbidity Index (1.10 vs. 1.15; P<.01).

“Other factors not assessed in the study are likely to be contributing to disease burden, and these unmeasured factors may affect men and women differently,” the authors noted.

The authors acknowledged several limitations of the study, including a geographically diverse sample which may have had an overrepresentation of patients who presented to their physician more frequently. Additionally, the self-reported nature of the questionnaire may also have impacted results.

In summary, the authors wrote, “Despite women and men having similar levels of physician-assessed disease activity and receiving similar treatment regimens, women reported a reduced quality of life and greater levels of disability and work impairment than men, while experiencing a lower comorbidity burden. 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.”

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