Background/Purpose:  Gender is an important patient characteristic that may potentially be used to predict clinical presentation, disease progression and therapeutic response. In recent studies, women with psoriatic arthritis (PsA) have reported less favorable function, increased fatigue, and decreased quality of life compared to men. Less is known about gender differences with other patient reported outcomes (PROs) such as pain, joint counts, and work limitations. Our purpose was to characterize gender differences in PROs, in participants of the Utah Psoriasis Initiative Arthritis Registry.

Methods: Baseline demographics, PsA characteristics, and PROs were compared between men and women enrolled between January 2010 and November 2014, using student’s t-test, Wilcoxon rank sum test, or Chi-square test. Work limitations were assessed in participants working for pay at the time of enrollment. Multivariate logistic regression was used to adjust for age, erythrocyte sedimentation rate (ESR) and PsA severity, as measured by the number of lifetime disease modifying anti-rheumatic drugs (DMARDs).

Results: Participants included 115 men and 138 women. Compared to men, women were older, had higher mean ESR, and were exposed to more DMARDs (Table 1). Women had less favorable unadjusted PROs for pain, fatigue, joint count, physical demands at work, work output, and function as measured by both Health Assessment Questionnaire (HAQ) and the Psoriatic Arthritis Screening and Evaluation (PASE) function subscale (Table 2). After adjustment for age, ESR, and number of lifetime DMARDs, these differences persisted for fatigue and HAQ.

Conclusion: Women experienced PsA differently than men, with higher fatigue and more functional limitations.  The etiology of the gender differences in PsA are unclear, and further research is indicated to better understand the role of hormones, gene expression, and other potential pathophysiologic differences between men and women. 

Table 1. Demographics, PsA characteristics, and therapies

PGAxBSA = psoriasis Physician Global Assessment x Body Surface Area. Table 2. Patient reported outcomes

Table 2:  Patient reported outcomes

*Adjusted for age, ESR, and number of lifetime biologic and non-biologic DMARD therapies. BASDAI#1 = question 1 from Bath Ankylosing Spondylitis Disease Activity Index. PASE = Psoriatic Arthritis Screening and Evaluation. WLQ = Work Limitations Questionnaire

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gender-differences-in-patient-reported-outcomes-pros-in-psoriatic-arthritis/