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 psoriatic arthritis (PsA) 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 PsA who initiated treatment with subcutaneous golimumab were included. Patients were grouped into age tertiles: Young: 19.7–47.0 years; Middle: 47.1–59.3; Old: 59.4–85.4) and further stratified by gender. The impact of age and gender on outcomes and retention were assessed with multivariate logistic and cox regressions, respectively, adjusting for age tertile, gender, and respective outcome at baseline.

Results: 281 patients were included with a mean (SD) age of 52.8 (13.2) years and disease duration of 6.1 (7.7) years. Across age tertiles, significant differences (p< 0.05) were observed at baseline in disease duration, weight, employment status, insurance coverage, previous smoking status, previous/concomitant use of oral steroids, HAQ-DI, TJC28, and SJC28. Gender, RF status, anti-CPP status, family history, current smoking status, previous/concomitant use of DMARDs, NSAIDs, or MTX, number of previous DMARDs, experience with biologics, enthesitis, and dactylitis, and PASI were statistically comparable. Between genders, significant differences were observed in weight, employment status, number of previous DMARDs, concomitant NSAIDs, and baseline HAQ-DI, TJC28, and SJC28.

Based on multivariate regression, patients in Young age tertiles (OR [95% CI]: 9.44 [3.88–23.0]) and Middle (2.5 [1.05–5.95]), along with male patients (2.07 [1.03-4.18]), were more likely to achieve MDA-LDA at 6 months. Compared to Old age tertile, achievement of MDA-LDA at 12 months (3.40 [1.36–8.48]), VLDA at 6 (6.69 [2.09–21.4]) and 12 (6.59 [1.92–22.7]) months, and HAQ< 0.5 at 6 (7.68 [3.23–18.3]) and 12 (4.84 [1.98–11.82]) months were more likely among patients in Young age tertile. Male patients were less likely have enthesitis (0.37 [0.15–0.87]) at 6 months and dactylitis at both 6 (0.27 [0.08–0.97]) and 12 (0.17 [0.03–0.88]) months. There was no association between age tertile or gender and PASI75 achievement.

In terms of safety, notable differences were observed across genders and age tertiles in both adverse event incidence and profile. Furthermore, male gender (HR [95%]: 1.66 [1.14-2.44]), but not age tertile, was associated with higher odds of retention.

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

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