TY - JOUR
T1 - Sex Differences in the Effectiveness of First-Line Tumor Necrosis Factor Inhibitors in Psoriatic Arthritis
T2 - Results From the European Spondyloarthritis Research Collaboration Network
AU - Hellamand, Pasoon
AU - van de Sande, Marleen G H
AU - Ørnbjerg, Lykke M
AU - Klausch, Thomas
AU - Eklund, Kari K
AU - Relas, Heikki
AU - Santos, Maria J
AU - Vieira-Sousa, Elsa
AU - Loft, Anne G
AU - Glintborg, Bente
AU - Østergaard, Mikkel
AU - Lindström, Ulf
AU - Wallman, Johan K
AU - Michelsen, Brigitte
AU - Fagerli, Karen M
AU - Castrejón, Isabel
AU - Gudbjornsson, Bjorn
AU - Love, Thorvardur J
AU - Vencovský, Jiří
AU - Nekvindová, Lucie
AU - Rotar, Žiga
AU - Tomšič, Matija
AU - Díaz-González, Federico
AU - Kenar, Gökçe
AU - Tuğsal, Handan Y
AU - Iannone, Florenzo
AU - Ramonda, Roberta
AU - Codreanu, Catalin
AU - Mogosan, Corina
AU - Nissen, Michael J
AU - Möller, Burkhard
AU - Hetland, Merete L
AU - van der Horst-Bruinsma, Irene E
N1 - COPECARE
This article is protected by copyright. All rights reserved.
PY - 2024/4
Y1 - 2024/4
N2 - OBJECTIVE: Women with psoriatic arthritis (PsA) may have reduced tumor necrosis factor inhibitor (TNFi) effectiveness compared to men. We examined sex differences in treatment response and retention rates during 24 months of follow-up among patients with PsA initiating their first TNFi.METHODS: Data from patients with PsA across 13 European Spondyloarthritis Research Collaboration Network registries starting their first TNFi were pooled. Logistic regression was used to analyze the association between sex and treatment response using low disease activity (LDA) according to the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) (<3.2) at six months as the primary outcome. Analyses were adjusted for age, country, conventional synthetic disease-modifying antirheumatic drug treatment, and TNFi start year. Retention rates were explored using the Kaplan-Meier estimator.RESULTS: We analyzed the treatment response of 7,679 patients with PsA (50% women) with available data on LDA at six months. At baseline, women and men had similar characteristics, including mean DAS28-CRP (women vs men, 4.4 [SD 1.2] vs 4.2 [SD 1.2]), though patient-reported outcome measures were worse in women. At six months, 64% of women and 78% of men had LDA (relative risk [RR] 0.82; 95% confidence interval [CI] 0.80-0.84). This difference was similar after adjustment (RR 0.83; 95% CI 0.81-0.85). TNFi retention rates were evaluated in 17,842 patients with PsA. Women had significantly lower retention rates than men at all time points (women 79%, 64%, and 50% vs men 88%, 77%, and 64% at 6, 12, and 24 months, respectively).CONCLUSION: Despite comparable disease characteristics at baseline, women with PsA have reduced treatment response and retention rates to their first TNFi, highlighting the need to consider sex differences in PsA research and management.
AB - OBJECTIVE: Women with psoriatic arthritis (PsA) may have reduced tumor necrosis factor inhibitor (TNFi) effectiveness compared to men. We examined sex differences in treatment response and retention rates during 24 months of follow-up among patients with PsA initiating their first TNFi.METHODS: Data from patients with PsA across 13 European Spondyloarthritis Research Collaboration Network registries starting their first TNFi were pooled. Logistic regression was used to analyze the association between sex and treatment response using low disease activity (LDA) according to the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) (<3.2) at six months as the primary outcome. Analyses were adjusted for age, country, conventional synthetic disease-modifying antirheumatic drug treatment, and TNFi start year. Retention rates were explored using the Kaplan-Meier estimator.RESULTS: We analyzed the treatment response of 7,679 patients with PsA (50% women) with available data on LDA at six months. At baseline, women and men had similar characteristics, including mean DAS28-CRP (women vs men, 4.4 [SD 1.2] vs 4.2 [SD 1.2]), though patient-reported outcome measures were worse in women. At six months, 64% of women and 78% of men had LDA (relative risk [RR] 0.82; 95% confidence interval [CI] 0.80-0.84). This difference was similar after adjustment (RR 0.83; 95% CI 0.81-0.85). TNFi retention rates were evaluated in 17,842 patients with PsA. Women had significantly lower retention rates than men at all time points (women 79%, 64%, and 50% vs men 88%, 77%, and 64% at 6, 12, and 24 months, respectively).CONCLUSION: Despite comparable disease characteristics at baseline, women with PsA have reduced treatment response and retention rates to their first TNFi, highlighting the need to consider sex differences in PsA research and management.
KW - Antirheumatic Agents/therapeutic use
KW - Arthritis, Psoriatic/drug therapy
KW - Female
KW - Humans
KW - Male
KW - Sex Characteristics
KW - Spondylarthritis/drug therapy
KW - Treatment Outcome
KW - Tumor Necrosis Factor Inhibitors/therapeutic use
KW - Tumor Necrosis Factor-alpha
UR - http://www.scopus.com/inward/record.url?scp=85186612218&partnerID=8YFLogxK
U2 - 10.1002/art.42758
DO - 10.1002/art.42758
M3 - Journal article
C2 - 37975166
SN - 2326-5191
VL - 76
SP - 587
EP - 598
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 4
ER -