Lubrano Ennio, Scriffignano Silvia, Fatica Mauro, Triggianese Paola, Conigliaro Paola, Perrotta Fabio Massimo, Chimenti Maria Sole
Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Via Giovanni Paolo II, C/da Tappino, 86100, Campobasso, Italy.
Rheumatology, Allergology and Clinical Immunology, Department of System Medicine, University of Rome Tor Vergata, Rome, Italy.
Rheumatol Ther. 2023 Jun;10(3):589-599. doi: 10.1007/s40744-023-00535-3. Epub 2023 Feb 16.
To assess any differences and similarities in psoriatic arthritis (PsA) between sexes. Any possible differences of psoriasis and its potential impact on disease burden between sexes with PsA were also evaluated.
Cross-sectional analysis of two longitudinal PsA cohorts. The impact of psoriasis on the PtGA was evaluated. Patients were stratified in four groups based on BSA. The median PtGA was then compared between the four groups. Moreover, a multivariate linear regression analysis was performed in order to evaluate associations between PtGA and skin involvement, split by sexes.
We enrolled 141 males and 131 females: PtGA, PtPnV, tender, swollen joint count, DAPSA, HAQ-DI, PsAID-12 were statistically significant higher in females (p ≤ 0.05). PASS "yes" was deemed more in males than in females and BSA was higher in males. MDA was present more in males than females. When the patients were stratified on BSA, median PtGA was not different between males and females with BSA = 0. Instead, in females with BSA > 0, a higher PtGA was observed compared to males with BSA > 0. There was not a statistically significant association between skin involvement and PtGA at linear regression analysis, even if a trend seems to be present in female.
Psoriasis is more present in males, but it seems to be related to a worse impact in females. In particular, a possible role of psoriasis as an influencing factor the PtGA was found. Moreover, female PsA patients tended to have more disease activity, worse function, and higher disease burden.
评估银屑病关节炎(PsA)在性别之间的异同。同时评估银屑病在患有PsA的不同性别之间的任何可能差异及其对疾病负担的潜在影响。
对两个纵向PsA队列进行横断面分析。评估银屑病对患者总体评估(PtGA)的影响。根据体表面积(BSA)将患者分为四组。然后比较四组之间的PtGA中位数。此外,进行多变量线性回归分析以评估按性别划分的PtGA与皮肤受累之间的关联。
我们纳入了141名男性和131名女性:女性的PtGA、患者疼痛和僵硬视觉模拟量表(PtPnV)、压痛关节计数、肿胀关节计数、疾病活动度银屑病关节炎疾病活动评分(DAPSA)、健康评估问卷残疾指数(HAQ-DI)、银屑病关节炎疾病活动指数-12(PsAID-12)在统计学上显著更高(p≤0.05)。男性的“银屑病存在(PASS)”为“是”的比例高于女性,且男性的BSA更高。男性的甲氨蝶呤(MDA)出现率高于女性。当根据BSA对患者进行分层时,BSA = 0的男性和女性之间的PtGA中位数没有差异。相反,在BSA>0的女性中,与BSA>0的男性相比,观察到更高的PtGA。在线性回归分析中,皮肤受累与PtGA之间没有统计学上的显著关联,即使在女性中似乎存在一种趋势。
银屑病在男性中更常见,但它似乎与女性中更严重的影响有关。特别是,发现银屑病可能作为影响PtGA的一个因素。此外,女性PsA患者往往具有更高的疾病活动度、更差的功能和更高的疾病负担。