Psoriatic Arthritis Disease Impact Is Greater in Women Than in Men

The disease impact of psoriatic arthritis (PsA) is greater in women than in men despite having similar disease activity and receiving similar treatment, according to study results published in The Journal of Rheumatology.

Researchers conducted a cross-sectional survey included 382 rheumatologists, 190 dermatologists, and 2270 patients with PsA (mean age 48.6 years; 46.1% women; n=595 in the US, n=369 in Spain, n=360 in Italy, n=360 in Germany, n=309 in the UK, n=277 in France). All data were collected between June and August 2018.

The researchers collected treatment data; demographic data; clinical data (tender joint count, affected body surface area, swollen joint count); quality of life (QOL) data via the EuroQoL 5-Dimension (EQ-5D) and Psoriatic Arthritis Impact of Disease (PsAID12) questionnaires; work productivity data via the Work Productivity and Impairment Index (WPAI); and disability data via the Health Assessment Questionnaire Disability Index (HAQ-DI). Parametric (Student t-test) and non-parametric tests (Wilcoxon Rank Sum, Chi-square, and Fisher’s exact test) were used to compare outcomes by sex.

Although men and women with PsA showed comparable levels of disease activity and biologic medication use, the PsAID12-defined disease impact was higher in women than in men (2.66 vs 2.27, respectively; P <.01). Women also showed worse outcomes than men for QOL (EQ-5D: 0.80 vs 0.82, respectively; P =.02), work activity impairment (WPAI: 27.9% vs 24.6%, respectively; P <.01), disability (HAQ-DI: 0.56 vs 0.41, respectively; P <.01). Comorbidity burden was lower among women than men (Charlson: 1.10 vs 1.15, respectively; P <.01).

Limitations of the study include potential recall bias, different base sizes for different variables, and the use of a list of comorbidities to collect fibromyalgia data.

The study authors conclude, “[W]omen reported a reduced [QOL] and greater levels of disability and work impairment than men, while experiencing a lower comorbidity burden.” This occurs despite “similar levels of physician-assessed disease activity and receiving similar treatment regimens.” The study researchers note that future research should examine the “additional burden experienced by women with PsA, and whether alternative treatment regimens would alleviate some of these differences.”

Disclosure: This clinical trial was supported by Janssen Research & Development, LLC. Please see the original reference for a full list of authors’ disclosures.

Reference

Gossec L, Walsh JA, Michaud K, et al. Women with psoriatic arthritis experience higher disease burden than men: findings from a real-world survey in the USA and Europe. J Rheumatol. Published online July 22, 2022. doi:10.3899/jrheum.220154