Clinical and instrumental characteristics of psoriatic arthritis in men and women. Data from a cohort observational study
- Authors: Korsakova Y.L.1, Korotaeva T.V.1, Loginova E.I.1, Gubar E.E.1, Petrov A.V.2,3,4, Patrikeeva I.M.5,6, Umnova I.F.7, Sorotskaya V.N.8, Pristavskii I.N.9, Sedunova M.V.9, Nasonov E.L.1,10
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Affiliations:
- Nasonova Research Institute of Rheumatology
- Vernadsky Crimean Federal University
- Semashko Clinical Hospital
- Ministry of Health of the Republic of Crimea
- Tyumen Regional Clinical Hospitai No. 1
- Tyumen Regional Healthcare Department
- Regional Clinical Hospital
- Tula State University
- Clinical Rheumatology Hospital No. 25
- Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 96, No 5 (2024)
- Pages: 479-485
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/256828
- DOI: https://doi.org/10.26442/00403660.2024.05.202703
- ID: 256828
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Abstract
Aim. To study and compare the clinical and imaging characteristics of psoriatic arthritis (PsA) in men and women.
Materials and methods. The study included 956 PsA patients observed in the Russian register, 411 (43%) men and 545 (57%) women. The average age of men/women was 46.0±16.50/50.7±17.20 years (p<0.001), the duration of PsA was 9.9±6.4/10.3±7.6 years (p>0.05), the age at the time of PsA establishment was 37.1±12.30/41.8±13.5 years (p<0.001). Rheumatological examination, X-ray of the pelvis, hands, feet were performed, the LEI, plantar fascia tenderness, body surface area (BSA), body mass index (BMI), CRP, HLA-B27 were determined. Patients filled out assessment scales of pain (Pain), disease activity (patient global assessment of disease activity – PGA), questionnaires HAQ-DI. The indices of Disease Activity in PSoriatic Arthritis (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), criteria of minimal disease activity (MDA) were evaluated.
Results. The following differences in the course of PsA in men/women were revealed: X-ray sacroiliitis was detected in 175 (42.6%)/153 (28.1%); p<0.001; the presence of erosions of the joints of the hands and feet – 138 (33.6%)/170 (31.2%); p=0.435; LEI≥3 – 34 (11.4%)/78 (20.9%); p=0.001; Pain – at 48.5±22.60/51.5±22.80 mm VAS; p=0.043; PGA – 50.2±23.07/54.0±21.91 mm VAS; p=0.010; moderate and severe functional disorders (HAQ-DI) were more often observed in women (p=0.002 and p<0.001, respectively); the average value of DAPSA is 26.4±16.8/31.9±22.58; p<0.001; average BASDAI value: 2.7±2.83/1.8±2.78; p<0.001; MDA was achieved in 13 (3.2%)/22 (4.1%); p=0.486; BSA>10% – 54 (13.1%)/102 (18.7%); p=0.021; comorbid diseases – 154 (37%)/277 (51%); p<0.001. At the time of inclusion in the register, the proportion of patients receiving biologic disease-modifying anti-rheumatic drugs was higher in the group of men.
Conclusion. Our data, based on a large cohort study, demonstrate that PsA debuts in women at a later age than in men, the course of the disease is characterized by higher activity of peripheral arthritis, more pronounced functional disorders and a high prevalence of comorbid diseases. This creates a heavier burden of PsA in women and indicates that gender is an important characteristic of the patient that should be used to predict the course, therapeutic response and progression of the disease.
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##article.viewOnOriginalSite##About the authors
Yulia L. Korsakova
Nasonova Research Institute of Rheumatology
Author for correspondence.
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-5968-2403
кандидат мед. наук, ст. науч. сотр. лаб. псориатического артрита
Russian Federation, MoscowTatiana V. Korotaeva
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0003-0579-1131
доктор мед. наук, нач. отд. спондилоартритов
Russian Federation, MoscowElena Iu. Loginova
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-6875-4552
кандидат мед. наук, ст. науч. сотр. лаб. псориатического артрита
Russian Federation, MoscowElena E. Gubar
Nasonova Research Institute of Rheumatology
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0001-5015-7143
кандидат мед. наук, науч. сотр. лаб. псориатического артрита
Russian Federation, MoscowAndriy V. Petrov
Vernadsky Crimean Federal University; Semashko Clinical Hospital; Ministry of Health of the Republic of Crimea
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-6398-2545
доктор мед. наук, проф. Медицинской академии ФГАОУ ВО «КФУ им. В.И. Вернадского», гл. внештат. специалист-ревматолог Минздрава Республики Крым
Russian Federation, Simferopol; Simferopol; SimferopolIrina M. Patrikeeva
Tyumen Regional Clinical Hospitai No. 1; Tyumen Regional Healthcare Department
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0003-0530-0080
зав. ревматологическим отд-нием ГБУЗ ТО ОКБ №1, гл. специалист-ревматолог Департамента здравоохранения Тюменской области
Russian Federation, Tyumen; TyumenIrina F. Umnova
Regional Clinical Hospital
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-2168-8954
врач-ревматолог
Russian Federation, OmskValentina N. Sorotskaya
Tula State University
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0003-3684-7310
доктор мед. наук, доц., проф. каф. внутренних болезней Медицинского института
Russian Federation, TulaIgor N. Pristavskii
Clinical Rheumatology Hospital No. 25
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-2189-3085
врач-ревматолог
Russian Federation, Saint PetersburgMariia V. Sedunova
Clinical Rheumatology Hospital No. 25
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-3355-2093
врач-ревматолог
Russian Federation, Saint PetersburgEvgeny L. Nasonov
Nasonova Research Institute of Rheumatology; Sechenov First Moscow State Medical University (Sechenov University)
Email: yulkorsakova@bk.ru
ORCID iD: 0000-0002-1598-8360
акад. РАН, доктор мед. наук, проф., науч. рук. ФГБНУ «НИИ ревматологии им. В.А. Насоновой», проф. каф. внутренних, профессиональных болезней и ревматологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)
Russian Federation, Moscow; MoscowReferences
- Ревматология. Российские клинические рекомендации. Под ред. Е.Л. Насонова. М.: ГЭОТАР-Медиа, 2020 [Revmatologiia. Rossiiskie klinicheskie rekomendatsii. Pod red. EL Nasonova. Moscow: GEOTAR-Media, 2020 (in Russian)].
- Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376(10):957-70. doi: 10.1056/NEJMra1505557
- Bragazzi NL, Bridgewood C, Watad A, et al. Sex-based medicine meets psoriatic arthritis: Lessons learned and to learn. Front Immunol. 2022;13:849560. doi: 10.3389/fimmu.2022.849560
- Tarannum S, Leung YY, Johnson SR, et al. Sex- and gender-related differences in psoriatic arthritis. Nat Rev Rheumatol. 2022;18(9):513-26. doi: 10.1038/s41584-022-00810-7
- Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: Development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-73. doi: 10.1002/art.21972
- Healy PJ, Helliwell PS. Measuring clinical enthesitis in psoriatic arthritis: Assessment of existing measures and development of an instrumentspecific to psoriatic arthritis. Arthritis Rheum. 2008;59(5):686-91. doi: 10.1002/art.23568
- Schoels MM, Aletaha D, Alasti F, Smolen JS. Disease activity in psoriatic arthritis (PsA): Defining remission and treatment success using the DAPSA score. Ann Rheum Dis. 2016;75(5):811-8. doi: 10.1136/annrheumdis-2015-207507
- Aletaha D, Alasti F, Smolen JS. Disease activity states of the DAPSA, a psoriatic arthritis specific instrument, are valid against functional status and structural progression. Ann Rheum Dis. 2017;76(2):418-21. doi: 10.1136/annrheumdis-2016-209511
- Garrett S, Jenkinson T, Kennedy LG, et al. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-91. PMID: 7699630
- Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: A proposed objective target for treatment. Ann Rheum Dis. 2010;69(1):48-53. doi: 10.1136/ard.2008.102053
- Braaten TJ, Zhang C, Presson AP, et al. Gender differences in psoriatic arthritis with fatigue, pain, function, and work disability. J Psoriasis Psoriatic Arthritis. 2019;4(4):192-7. doi: 10.1177/2475530319870776
- Duruöz MT, Gezer HH, Nas K, et al. Gender-related differences in disease activity and clinical features in patients with peripheral psoriatic arthritis: A multi-center study. Joint Bone Spine. 2021;88(4):105177. doi: 10.1016/j.jbspin.2021.105177
- Passia E, Vis M, Coates LC, et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22. doi: 10.1186/s13075-021-02680-y
- Van Kuijk AWR, Nurmohamed MT, Siebert S, et al. Gender-specific differences in patients with psoriatic arthritis receiving ustekinumab or tumour necrosis factor inhibitor: Real-world data. Rheumatology (Oxford). 2023;62(10):3382-90. doi: 10.1093/rheumatology/kead089
- Kojanova M, Fialova J, Cetkovska P, et al. Demographic data, comorbidities, quality of life, and survival probability of biologic therapy associated with sex-specific differences in psoriasis in the Czech Republic. Dermatol Ther. 2021;34(2):e14849. doi: 10.1111/dth.14849
- Gossec L, Walsh JA, Michaud K, et al. Women with psoriatic arthritis experience higher disease burden than men: findings from a real-world survey in the United States and Europe. J Rheumatol. 2023;50(2):192-6. doi: 10.3899/jrheum.220154
- Coates LC, van der Horst-Bruinsma IE, Lubrano E, et al. Sex-specific differences in patients with psoriatic arthritis: A systematic review. J Rheumatol. 2023;50(4):488-96. doi: 10.3899/jrheum.220386