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Gender differences in biologic treatment outcomes-a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers

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@article{14a20b7d07444b78b10eaee142d28ed7,
title = "Gender differences in biologic treatment outcomes-a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers",
abstract = "Objective: We aimed to investigate gender differences in disease manifestations, patient-reported outcomes, comorbidities and treatment effectiveness among patients with PsA treated with their first TNFα inhibitor (TNFI).Methods: In this observational cohort study, the DANBIO register provided prospectively collected data on PsA patients who initiated their first TNFI in 2000-15. Comorbidity information was achieved from the Danish Nationwide Patient Register. Response to treatment was assessed according to EULAR and ACR criteria at 3 and 6 months. Cox and logistic regression models analysed the impact of gender on TNFI persistence and response, respectively, while adjusting for a priori selected confounders including clinical-, laboratory- and patient-reported factors, comorbidities and lifestyle characteristics.Results: A total of 1750 PsA patients (935 women) were included. At baseline, women were older (49 years/47 years), more often smokers (32{\%}/26{\%}), had worse patient-reported scores (e.g. global score 71 mm/65 mm) and higher frequencies of hospital-diagnosed anxiety or depression (7{\%}/4{\%}) and chronic pulmonary disease (7{\%}/3{\%}) than men (all P < 0.01). Median TNFI persistence was 3.8 years (95{\%} CI: 3.0, 5.7) in men vs 1.4 (1.1, 1.8) in women (P < 0.001). Men had higher odds of achieving response after 3 and 6 months, for example, adjusted odds ratio = 3.2 (1.6, 6.1) for EULAR good/moderate response (vs women) at 6 months.Conclusion: Male gender was strongly associated with greater TNFI treatment effectiveness. Adjustment for baseline risk factors including patient-reported outcomes, disease activity, comorbidities and lifestyle factors did not influence this relationship, which suggests a role of biological factors.",
keywords = "Anxiety/epidemiology, Arthritis, Psoriatic/drug therapy, Biological Products/therapeutic use, Comorbidity/trends, Delivery of Health Care/statistics & numerical data, Denmark/epidemiology, Depression/epidemiology, Female, Follow-Up Studies, Humans, Lung Diseases/epidemiology, Male, Medication Adherence, Outcome Assessment (Health Care), Prospective Studies, Registries, Risk Assessment/methods, Sex Distribution, Sex Factors, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha/antagonists & inhibitors",
author = "Pil H{\o}jgaard and Christine Ballegaard and Ren{\'e} Cordtz and Kristian Zobbe and Marianne Clausen and Bente Glintborg and Kristensen, {Lars Erik} and Lene Dreyer",
note = "COPECARE",
year = "2018",
month = "9",
day = "1",
doi = "10.1093/rheumatology/key140",
language = "English",
volume = "57",
pages = "1651--1660",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "9",

}

RIS

TY - JOUR

T1 - Gender differences in biologic treatment outcomes-a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers

AU - Højgaard, Pil

AU - Ballegaard, Christine

AU - Cordtz, René

AU - Zobbe, Kristian

AU - Clausen, Marianne

AU - Glintborg, Bente

AU - Kristensen, Lars Erik

AU - Dreyer, Lene

N1 - COPECARE

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objective: We aimed to investigate gender differences in disease manifestations, patient-reported outcomes, comorbidities and treatment effectiveness among patients with PsA treated with their first TNFα inhibitor (TNFI).Methods: In this observational cohort study, the DANBIO register provided prospectively collected data on PsA patients who initiated their first TNFI in 2000-15. Comorbidity information was achieved from the Danish Nationwide Patient Register. Response to treatment was assessed according to EULAR and ACR criteria at 3 and 6 months. Cox and logistic regression models analysed the impact of gender on TNFI persistence and response, respectively, while adjusting for a priori selected confounders including clinical-, laboratory- and patient-reported factors, comorbidities and lifestyle characteristics.Results: A total of 1750 PsA patients (935 women) were included. At baseline, women were older (49 years/47 years), more often smokers (32%/26%), had worse patient-reported scores (e.g. global score 71 mm/65 mm) and higher frequencies of hospital-diagnosed anxiety or depression (7%/4%) and chronic pulmonary disease (7%/3%) than men (all P < 0.01). Median TNFI persistence was 3.8 years (95% CI: 3.0, 5.7) in men vs 1.4 (1.1, 1.8) in women (P < 0.001). Men had higher odds of achieving response after 3 and 6 months, for example, adjusted odds ratio = 3.2 (1.6, 6.1) for EULAR good/moderate response (vs women) at 6 months.Conclusion: Male gender was strongly associated with greater TNFI treatment effectiveness. Adjustment for baseline risk factors including patient-reported outcomes, disease activity, comorbidities and lifestyle factors did not influence this relationship, which suggests a role of biological factors.

AB - Objective: We aimed to investigate gender differences in disease manifestations, patient-reported outcomes, comorbidities and treatment effectiveness among patients with PsA treated with their first TNFα inhibitor (TNFI).Methods: In this observational cohort study, the DANBIO register provided prospectively collected data on PsA patients who initiated their first TNFI in 2000-15. Comorbidity information was achieved from the Danish Nationwide Patient Register. Response to treatment was assessed according to EULAR and ACR criteria at 3 and 6 months. Cox and logistic regression models analysed the impact of gender on TNFI persistence and response, respectively, while adjusting for a priori selected confounders including clinical-, laboratory- and patient-reported factors, comorbidities and lifestyle characteristics.Results: A total of 1750 PsA patients (935 women) were included. At baseline, women were older (49 years/47 years), more often smokers (32%/26%), had worse patient-reported scores (e.g. global score 71 mm/65 mm) and higher frequencies of hospital-diagnosed anxiety or depression (7%/4%) and chronic pulmonary disease (7%/3%) than men (all P < 0.01). Median TNFI persistence was 3.8 years (95% CI: 3.0, 5.7) in men vs 1.4 (1.1, 1.8) in women (P < 0.001). Men had higher odds of achieving response after 3 and 6 months, for example, adjusted odds ratio = 3.2 (1.6, 6.1) for EULAR good/moderate response (vs women) at 6 months.Conclusion: Male gender was strongly associated with greater TNFI treatment effectiveness. Adjustment for baseline risk factors including patient-reported outcomes, disease activity, comorbidities and lifestyle factors did not influence this relationship, which suggests a role of biological factors.

KW - Anxiety/epidemiology

KW - Arthritis, Psoriatic/drug therapy

KW - Biological Products/therapeutic use

KW - Comorbidity/trends

KW - Delivery of Health Care/statistics & numerical data

KW - Denmark/epidemiology

KW - Depression/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Lung Diseases/epidemiology

KW - Male

KW - Medication Adherence

KW - Outcome Assessment (Health Care)

KW - Prospective Studies

KW - Registries

KW - Risk Assessment/methods

KW - Sex Distribution

KW - Sex Factors

KW - Time Factors

KW - Treatment Outcome

KW - Tumor Necrosis Factor-alpha/antagonists & inhibitors

U2 - 10.1093/rheumatology/key140

DO - 10.1093/rheumatology/key140

M3 - Journal article

VL - 57

SP - 1651

EP - 1660

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 9

ER -

ID: 56058575