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Sex-Related Differences in Psoriatic Arthritis Randomized Clinical Trials
According to a study published in The Lancet Rheumatology, the biologic sex of patients with psoriatic arthritis influences their response to advanced therapies; however, the effect varies by drug class.
Researchers aimed to investigate sex-related differences in patient characteristics, efficacy, and safety outcomes of advanced therapies in psoriatic arthritis through randomized controlled trials. The study included 54 trials with a total of 22,621 participants, of which 50.9% were female and 49.1% were male.
The findings revealed notable sex-related variations in baseline characteristics. Male patients exhibited lower baseline tender joint count, health assessment questionnaire scores, pain scores, Patient Global Assessment, and Physician Global Assessment compared to female patients. However, male patients had higher baseline Psoriasis Area and Severity Index scores and C-reactive protein concentrations.
When assessing treatment efficacy, the study found that American College of Rheumatology (ACR) 20 and ACR50 response rates varied across drug classes. Male patients generally showed higher response rates with IL-17 inhibitors, IL-23 inhibitors, IL-12 and IL-23 inhibitors, and tumor necrosis factor (TNF) inhibitors, but no significant difference with Janus kinase (JAK) and tyrosine kinase 2 (TYK2) inhibitors.
Similarly, male patients were more likely to reach minimal disease activity with most drug classes, including IL-17 inhibitors, IL-23 inhibitors, TNF inhibitors, and JAK and TYK2 inhibitors.
“Selective reporting might have influenced these results. Future trials should report baseline characteristics and endpoint results by sex,” the authors concluded.
Reference
Eder L, Mylvaganam S, Pardo Pardo J, et al. Sex-related differences in patient characteristics, and efficacy and safety of advanced therapies in randomised clinical trials in psoriatic arthritis: a systematic literature review and meta-analysis. Lancet Rheumatol. 2023;5(12):e716-e727. doi:10.1016/S2665-9913(23)00264-3
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