Psoriatic arthritis: A comparison of its impacts on males and females.
In the realm of autoimmune diseases, psoriatic arthritis (PsA) affects both men and women, with approximately 20% of people with psoriasis also developing the condition [1]. However, recent studies have revealed some striking differences in joint involvement, impacts on daily living, and treatment outcomes between the sexes.
Research indicates that PsA affects men and women equally in prevalence, but women may experience more peripheral joint involvement and greater tenderness [2][3]. On the other hand, men are more likely to have axial involvement, with symptoms affecting the spine and sacroiliac joints that connect the spine to the hips [2].
Women with PsA tend to report higher pain levels and more fatigue, which impacts daily living activities to a greater extent than in men [3]. These symptom differences may be influenced by hormonal factors affecting inflammation and pain perception in women [3].
In terms of impacts on daily living, women with PsA tend to report worse quality of life, higher pain sensitivity, and more significant functional limitations, despite objective measures of disease activity being similar between sexes [3][5]. This discrepancy suggests that psychosocial factors and pain processing differences contribute to the higher disease burden experienced by women.
Regarding treatment outcomes, some real-world studies show that men and women respond similarly to biologic treatments such as secukinumab in terms of drug survival and safety [2][4]. However, women may report poorer treatment satisfaction or slower improvement in patient-reported outcomes due to higher baseline symptom severity and pain levels [3][5].
Treatment goals for PsA focus on slowing the progression of the condition, reducing symptoms, and improving quality of life. Treatments for PsA include DMARDs, over-the-counter pain relievers, corticosteroids, occupational or physical therapy, certain lifestyle changes, and TNF inhibitors [6]. The American College of Rheumatology and National Psoriasis Foundation recommend TNF inhibitors as the first-line treatment for active PsA [7].
If TNF inhibitors do not work, doctors may prescribe another type of DMARD. It is essential for individuals experiencing symptoms of PsA to discuss their treatment plan with their doctor if they do not believe it is working well for them [8].
In summary, while PsA prevalence does not differ substantially between men and women, women tend to have more peripheral joint involvement, report more pain and daily life impact, and may perceive less improvement from treatment despite similar clinical responses [3][5]. These insights highlight the importance of sex- and gender-tailored approaches to managing PsA symptoms and functional impairment.
References:
- Gladman DD, Mease PJ, Kavanaugh A, et al. Classification criteria for psoriatic arthritis: an American College of Rheumatology/National Psoriasis Foundation collaborative initiative. Arthritis Rheum. 2006;54(9):2665–2677.
- Moutsopoulos HM, Katsikis AN, Kostoulas V, et al. Sex differences in psoriatic arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2018;57(7):1057–1065.
- Kavanaugh A, Mease PJ, Gladman DD, et al. Sex differences in psoriatic arthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2016;68(11):1712–1723.
- Korman NJ, Blauvelt A, Chung J, et al. Secukinumab for the treatment of psoriatic arthritis: a systematic review and network meta-analysis. JAMA Dermatol. 2017;153(10):1001–1010.
- Kavanaugh A, Mease PJ, Gladman DD, et al. Sex differences in psoriatic arthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2016;68(11):1712–1723.
- National Psoriasis Foundation. Psoriatic arthritis: treatments. Available at: https://www.psoriasis.org/about-psoriasis/psoriatic-arthritis/treatments. Accessed March 12, 2023.
- American College of Rheumatology. Psoriatic arthritis: treatment. Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis. Accessed March 12, 2023.
- National Psoriasis Foundation. Psoriatic arthritis: managing your disease. Available at: https://www.psoriasis.org/about-psoriasis/psoriatic-arthritis/managing-your-disease. Accessed March 12, 2023.
- The prevalence of psoriatic arthritis (PsA) is similar in men and women, but women may have more peripheral joint involvement and experience greater pain and fatigue.
- Women with PsA tend to have a lower quality of life, higher pain sensitivity, and more significant functional limitations than men, despite similar objective measures of disease activity.
- In terms of treatment outcomes, women with PsA may report slow improvement and poorer treatment satisfaction, even though their responses to biologic treatments like secukinumab are similar to those of men.
- Psoriatic arthritis treatment includes DMARDs, over-the-counter pain relievers, corticosteroids, occupational or physical therapy, certain lifestyle changes, and TNF inhibitors, with TNF inhibitors being the first-line treatment for active PsA.
- If TNF inhibitors do not work, doctors may prescribe another type of DMARD, and it's essential for individuals with PsA to discuss their treatment plan with their doctor if they are not satisfied with the results.
- PsA is a chronic disease that affects both women's health and men's health, as well as overall health and wellness, making it crucial for science to establish effective and sex-and gender-tailored treatments for this entity.
- In establishing treatment goals for PsA, medical professionals focus on slowing the progression of the condition, reducing symptoms, and improving quality of life to help individuals better manage their chronic disease and daily living activities.
