Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1913-1920. doi: 10.1111/jdv.15733. Epub 2019 Jul 7.
Female sex has been reported as a predictor for treatment discontinuation with biological therapies for psoriasis, although reasons remain unclear. It can be hypothesized that lower satisfaction with biological treatment in women might add to the lower drug survival rates.
To identify possible differences in satisfaction with biological treatment between female and male patients using the Treatment Satisfaction Questionnaire for Medication (TSQM).
Data of psoriasis patients treated with biologics were obtained from the prospective, multicentre, daily-practice BioCAPTURE registry. Longitudinal TSQM data were analysed by linear mixed models. Relevant patient characteristics were incorporated as possible confounding factors. Post hoc analysis of adverse events was performed in order to investigate differences between sexes.
We included 315 patients with 396 corresponding treatment episodes (137 adalimumab, 90 etanercept, 137 ustekinumab, 24 secukinumab and 8 infliximab). Almost forty per cent of the patients were female. Women had significantly lower baseline PASI scores (P = 0.01). Longitudinal analyses demonstrated lower TSQM scores for 'side-effects' (P = 0.05) and 'global satisfaction' (P = 0.01) in female patients compared with male patients over 1 year of treatment. Women reported more relevant adverse events in the context of biologic treatment compared to men (rate ratio 1.79; P < 0.001), with more fungal (rate ratio 2.20; P = 0.001) and herpes simplex infections (rate ratio 3.25; P = 0.005).
This study provides a prospective, longitudinal analysis of treatment satisfaction with biologics in female and male patients with psoriasis. Women were slightly less satisfied with treatment regarding side-effects and global satisfaction. Differences in treatment satisfaction and side-effects might add to the fact that women discontinue biological treatments more often.
已有研究报道，女性是生物疗法治疗银屑病过程中停药的预测因素，尽管具体原因尚不清楚。可以假设，女性对生物治疗的满意度较低可能导致药物生存率降低。
使用治疗药物满意度问卷（TSQM），确定女性和男性患者在生物治疗满意度方面的可能差异。
从前瞻性、多中心、日常实践的 BioCAPTURE 登记处获取接受生物制剂治疗的银屑病患者的数据。通过线性混合模型分析纵向 TSQM 数据。将相关患者特征纳入可能的混杂因素。为了探究性别差异，进行了不良事件的事后分析。
我们纳入了 315 名患者，共 396 次相应的治疗期（阿达木单抗 137 次，依那西普 90 次，乌司奴单抗 137 次，司库奇尤单抗 24 次，英夫利昔单抗 8 次）。近 40%的患者为女性。女性患者的基线 PASI 评分明显较低（P=0.01）。纵向分析显示，与男性患者相比，女性患者在接受生物治疗 1 年以上时，TSQM 对“副作用”（P=0.05）和“总体满意度”（P=0.01）的评分较低。与男性相比，女性在接受生物治疗时报告了更多相关的不良事件（率比 1.79；P<0.001），真菌感染（率比 2.20；P=0.001）和单纯疱疹感染（率比 3.25；P=0.005）的发生率更高。
本研究对女性和男性银屑病患者的生物治疗满意度进行了前瞻性、纵向分析。女性在副作用和总体满意度方面对治疗的满意度略低。治疗满意度和副作用方面的差异可能是女性更频繁地停止生物治疗的原因之一。
