Background/Purpose: Gender and age have been previously identified as independent predictors of response to anti-TNFs. The aim of this analysis was to compare, between genders and age groups, the profile and outcomes of ankylosing spondylitis (AS) patients treated with golimumab during routine Canadian care.

Methods: This is a post-hoc analysis of data from the Biologic Treatment Registry Across Canada (BioTRAC). Patients with AS who initiated treatment with subcutaneous golimumab were included. Patients were grouped into age tertiles (Young: 18.5–39.1 years; Middle: 39.2–51.2; Old: 51.3–90.2) and further stratified by gender. The impact of age and gender on outcomes (ASDAS clinically important improvement [CII; Δ≥1.1], major improvement [MI; Δ≥2.0], and HAQ< 0.5) and treatment retention were assessed with multivariate logistic and cox regressions, respectively, adjusting for age tertile, gender, HLA-B27 and respective outcome at baseline.

Results: 421 patients were included with a mean (SD) age of 45.7 (13.3) years and disease duration of 6.0 (10.1) years. Across age tertiles, significant differences (p< 0.05) were observed at baseline in disease duration, employment status, insurance coverage, previous smoking status, number of previous DMARDs, previous use of NSAIDs or MTX, concomitant use of DMARDs or oral steroids, and BASFI. Gender, RF status, anti-CPP status, family history, current smoking status, previous use of DMARDs or oral steroids, experience with biologics, concomitant NSAIDs or MTX, ASDAS, BASDAI, HAQ, enthesitis, and dactylitis were comparable. Between genders, significant differences were observed in weight, current/previous smoking status, and BASDAI.

Based on multivariate regression, patients in Young age tertile vs. Old were more likely to achieve ASDAS-MI at 12 months (OR [95% CI]: 3.53 [1.00–12.41]) and HAQ< 0.5 at both 6 (2.84 [1.37–5.89]) and 12 (2.63 [1.22–5.70]) months. Achievement of ASDAS-MI at 12 months was also more likely among male patients (4.16 [1.31–13.23]). There was no impact of gender or age tertiles on ASDAS-CII achievement.

With respect to treatment retention, male patients were more likely to stay on golimumab treatment (HR [95%]: 2.32 [1.11-4.76]). However, age tertile was not associated with retention.

Across age tertiles, AE incidence was comparable; however, SAE incidence was substantially higher among older patients. Between genders, AE incidence was lower among males, with no differences in SAE incidence.

Conclusion: Significant variations in baseline characteristics, treatment outcomes, and safety profile exist across age groups and gender.

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-gender-and-age-on-ankylosing-spondylitis-patient-profiles-at-golimumab-initiation-and-12-month-outcomes/