Women with Psoriatic Arthritis Experience Higher Disease Burden than Men: Findings from a Real-World Survey in the USA and Europe
Abstract
Objective Although psoriatic arthritis (PsA) is equally present in men and women, sex may influence clinical manifestations and the impact of disease on patients' lives. This study assessed differences in clinical characteristics, disability, quality of life (QoL) and work productivity by sex in real-world practice.
Methods A cross-sectional survey of rheumatologists/dermatologists and their PsA patients, conducted in France, Germany, Italy, Spain, the UK and the USA between Jun-Aug 2018. Data collected included demographic, treatment use and clinical characteristics (Tender Joint Count, TJC; Swollen Joint Count, SJC; Body Surface Area, BSA, affected by psoriasis) and QoL (EuroQoL 5-Dimension questionnaire, EQ-5D; Psoriatic Arthritis Impact of Disease, PsAID12), disability (Health Assessment Questionnaire Disability Index, HAQ-DI) and work productivity (Work Productivity and Impairment Index, WPAI). Outcomes were compared between men and women using parametric and non-parametric tests, as appropriate.
Results Of 2,270 patients (mean ±standard deviation (SD) age: 48.6 ±13.3 years, disease duration: 4.9 ±6.0 years), 1,047 (46.1%) were women. Disease duration, disease presentation and biologic use (mean 54.2%) were comparable between women and men. Women reported worse QoL (EQ-5D: 0.80 ±0.18 vs 0.82 ±0.17, p=0.02), greater disability (HAQ-DI: 0.56 ±0.60 vs 0.41 ±0.52, p <0.01) and work activity impairment (WPAI: 27.9% ±22.0 vs 24.6% ±22.4, p <0.01) than men. However, women had a lower burden of comorbidities (Charlson: 1.10 ±0.51 vs 1.15 ±0.58, p <0.01).
Conclusion In patients with similar PsA disease activity and treatment, women experienced greater disease impact than men. This represents a significant consideration for the therapeutic management of PsA.