Gender Complexities in Psoriatic Arthritis Treatment Outcomes Save

Analysis of a German psoriatic arthritis (PsA) patients registry demonstrates sex-specific differences regarding clinical manifestation and treatment outcomes, especially with regard to drug discontinuations.

This study enrolled 800 PsA (457 female, 343 male) bionaïve patients with PsA from the RABBIT-SpA register were included at the start of their first b/tsDMARD. 

Clinical profiles

• Females had more severe disease with more severe joint involvement and higher disease activity, more pain, and greater functional limitations
• Males had more pronounced skin involvement and a higher prevalence of nail psoriasis. 

Drug Persistence

• Females had lower treatment persistence rates, for all first-line b/tsDMARDs, TNFi and IL17i therapies. 
• At 12 months, 52% of females and 68% of males remained on their initial b/tsDMARD therapy. 

Discontinuations

• Males more frequently discontinued due to lack of efficacy or remission
• Females discontinued treatment mostly due to adverse events
• While female patients had more overall adverse events, males reported more serious adverse events (twice the rate)

Gender-specific treatment strategies are needed, with a need for more comprehensive research into biological and sociocultural factors influencing therapy persistence and reasons for discontinuation in real-world settings

How can we tailor treatment strategies to narrow the gender gap that adversely affects female patients with PsA?