Sex Differences in the Effectiveness of First-Line Tumor Necrosis Factor Inhibitors in Psoriatic Arthritis: Results From the European Spondyloarthritis Research Collaboration Network.

Autor: Hellamand P; Amsterdam University Medical Centers, Amsterdam, The Netherlands., van de Sande MGH; Amsterdam University Medical Centers, Amsterdam, The Netherlands., Ørnbjerg LM; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet, Glostrup, Denmark., Klausch T; Amsterdam University Medical Centers, Amsterdam, The Netherlands., Eklund KK; Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Relas H; Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Santos MJ; Hospital Garcia de Orta, Almada, Portugal., Vieira-Sousa E; Hospital de Santa Maria, Lisbon, Portugal., Loft AG; Aarhus University Hospital, Aarhus, Denmark., Glintborg B; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet, Glostrup, University of Copenhagen, Copenhagen, Denmark., Østergaard M; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet, Glostrup, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Lindström U; Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden., Wallman JK; Skåne University Hospital and Lund University, Lund, Sweden., Michelsen B; Diakonhjemmet Hospital, Oslo and Sørlandet Hospital, Kristiansand, Norway., Fagerli KM; Diakonhjemmet Hospital, Oslo, Norway., Castrejón I; Hospital General, Universitario Gregorio Marañón, Madrid, Spain., Gudbjornsson B; Landspitali University Hospital and University of Iceland, Reykjavik, Iceland., Love TJ; Landspitali University Hospital and University of Iceland, Reykjavik, Iceland., Vencovský J; Institute of Rheumatology and Charles University, Prague, Czech Republic., Nekvindová L; Charles University, Prague, Czech Republic., Rotar Ž; University Medical Centre Ljubljana and University of Ljubljana, Ljubljana, Slovenia., Tomšič M; University Medical Centre Ljubljana, Ljubljana, Slovenia., Díaz-González F; Universidad de La Laguna, La Laguna, Spain., Kenar G; Dokuz Eylul University School of Medicine, Izmir, Turkey., Tuğsal HY; Dokuz Eylul University School of Medicine, Izmir, Turkey., Iannone F; University of Bari, Bari, Italy., Ramonda R; University of Medicine, Padova, Italy., Codreanu C; University of Medicine and Pharmacy, Bucharest, Romania., Mogosan C; University of Medicine and Pharmacy, Bucharest, Romania., Nissen MJ; Geneva University Hospital, Geneva, Switzerland., Möller B; Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland., Hetland ML; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet, Glostrup, University of Copenhagen, Copenhagen, Denmark., van der Horst-Bruinsma IE; Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2024 Apr; Vol. 76 (4), pp. 587-598. Date of Electronic Publication: 2024 Feb 25.
DOI: 10.1002/art.42758
Abstrakt: 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.
(© 2023 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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