Gossec Laure, Walsh Jessica A, Michaud Kaleb, Peterson Steve, Holdsworth Elizabeth A, Karyekar Chetan S, Booth Nicola, Chakravarty Soumya D, Ogdie Alexis
L. Gossec, MD, PhD, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM and Sorbonne Université, and Rheumatology Department, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France;
J.A. Walsh, MD, University of Utah Health and Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah, USA.
J Rheumatol. 2023 Feb;50(2):192-196. doi: 10.3899/jrheum.220154. Epub 2022 Aug 15.
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.
A cross-sectional survey of rheumatologists/dermatologists and their patients with PsA was conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States between June and August 2018. Data collected included demographics, treatment use, clinical characteristics (tender joint count, swollen joint count, body surface area affected by psoriasis), 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 nonparametric tests, as appropriate.
Of 2270 patients (mean age 48.6 [SD 13.3] yrs, mean disease duration 4.9 [SD 6.0] yrs), 1047 (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 [SD 0.2] vs 0.82 [SD 0.2]; = 0.02), greater disability (HAQ-DI: 0.56 [SD 0.6] vs 0.41 [SD 0.5]; < 0.01) and work activity impairment (WPAI: 27.9% [SD 22.0] vs 24.6% [SD 22.4]; < 0.01) than men. However, women had a lower burden of comorbidities (Charlson Comorbidity Index: 1.10 [SD 0.5] vs 1.15 [SD 0.6]; < 0.01).
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.
尽管银屑病关节炎（PsA）在男性和女性中发病率相同，但性别可能会影响临床表现以及疾病对患者生活的影响。本研究评估了在实际临床中，PsA患者的临床特征、残疾程度、生活质量（QOL）和工作效率在性别上的差异。
2018年6月至8月间，在法国、德国、意大利、西班牙、英国和美国对风湿病学家/皮肤科医生及其PsA患者进行了一项横断面调查。收集的数据包括人口统计学信息、治疗用药情况、临床特征（压痛关节计数、肿胀关节计数、银屑病累及的体表面积）、生活质量（欧洲五维健康量表问卷[EQ-5D]、银屑病关节炎疾病影响量表[PsAID12]）、残疾程度（健康评估问卷残疾指数[HAQ-DI]）和工作效率（工作效率和活动能力受损指数[WPAI]）。根据情况，使用参数检验和非参数检验对男性和女性的结果进行比较。
在2270例患者中（平均年龄48.6岁[标准差13.3]，平均病程4.9年[标准差6.0]），1047例（46.1%）为女性。女性和男性在病程、疾病表现和生物制剂使用情况（平均54.2%）方面具有可比性。女性报告的生活质量较差（EQ-5D：0.80[标准差0.2]对0.82[标准差0.2]；P=0.02），残疾程度更高（HAQ-DI：0.56[标准差0.6]对0.41[标准差0.5]；P<0.01），工作活动能力受损情况更严重（WPAI：27.9%[标准差22.0]对24.6%[标准差22.4]；P<0.01）。然而，女性的合并症负担较低（查尔森合并症指数：1.10[标准差0.5]对1.15[标准差0.6]；P<0.01）。
在PsA疾病活动度和治疗情况相似的患者中，女性比男性经历了更大的疾病影响。这是PsA治疗管理中一个需要重要考虑的因素。
