Department of Rheumatology, Sint Maartenskliniek.
Department of Dermatology, Radboud University Medical Center.
Rheumatology (Oxford). 2022 Feb 2;61(2):770-774. doi: 10.1093/rheumatology/keab338.
To assess sex differences in disease activity parameters and health-related quality of life in PsA, and to assess whether determinants associated with not reaching treatment target differed between men and women.
Routine practice data of 855 PsA patients, who were all tightly monitored and treated, was used. Sex differences including, but not limited to, PsA Disease Activity Score (PASDAS), skin/nail disease, SF-12 PCS/MCS, and inflammatory back pain (IBP) were assessed. Multivariate analyses were used to examine determinants associated with not reaching treatment target (PASDAS ≤ 3.2) in men and women.
Women had worse scores for-among others-swollen and tender joints, CRP, enthesitis and function (all P < 0.001). Higher PASDAS scores were found for women [3.5 (1.5)] than men [2.7 (1.5), P < 0.001]. Likewise, women were more often not at PASDAS treatment target (OR = 2.03, P < 0.001). No difference in current medication use was found. Nail disease, IBP, number of DMARDs used (past and current), and BMI were associated with not reaching treatment target in the overall sample. For women, but not men, BMI was associated with not reaching PASDAS low disease activity (LDA) (OR between 2.41 and 3.43, P < 0.001).
Women with PsA in a tightly monitored and treated setting have more severe disease than men. This is demonstrated by worse scores for women in both subjective and objective disease activity measures, in addition to women less often reaching the treatment target. Notably, being overweight is associated with higher disease activity in women, but not men.
评估银屑病关节炎（PsA）患者的疾病活动参数和健康相关生活质量的性别差异，并评估未达到治疗目标的相关决定因素在男性和女性之间是否存在差异。
使用 855 名接受严密监测和治疗的 PsA 患者的常规实践数据。评估了性别差异，包括但不限于银屑病关节炎疾病活动评分（PASDAS）、皮肤/指甲疾病、SF-12 PCS/MCS 和炎症性背痛（IBP）。使用多变量分析来检查男性和女性未达到治疗目标（PASDAS≤3.2）的相关决定因素。
女性在肿胀和压痛关节、CRP、肌腱端炎和功能等方面的评分均较差（均 P<0.001）。女性的 PASDAS 评分更高[3.5（1.5）]，而男性的 PASDAS 评分较低[2.7（1.5），P<0.001]。同样，女性达到 PASDAS 治疗目标的比例较低（OR=2.03，P<0.001）。未发现当前用药的差异。指甲疾病、IBP、过去和当前使用的 DMARD 数量以及 BMI 与总体样本未达到治疗目标相关。对于女性，但不是男性，BMI 与未达到 PASDAS 低疾病活动（LDA）相关（OR 为 2.41 至 3.43，P<0.001）。
在严密监测和治疗的环境中，女性银屑病关节炎患者的疾病比男性更为严重。这表现为女性在主观和客观疾病活动指标上的评分均较差，并且女性达到治疗目标的比例较低。值得注意的是，超重与女性的疾病活动增加相关，但与男性无关。
