Sex-Specific Differences in Patients With Psoriatic Arthritis: A Systematic Review.

Area of Science:

• Rheumatology
• Immunology
• Dermatology

Background:

• Psoriatic arthritis (PsA) affects both sexes, but sex-specific differences in clinical presentation, disease activity, and treatment outcomes are not fully understood.
• Understanding these differences is crucial for personalized treatment strategies and improving patient-reported outcomes (PROs).

Approach:

• A systematic review of published literature was conducted, searching major databases (MEDLINE, Embase, Cochrane) and clinical trial registries.
• Included studies (n=27) compared outcomes by sex in adults with PsA, focusing on data from January 2015 to November 2020.
• Extracted data included patient characteristics, disease activity measures, and PROs.

Key Points:

• Women with PsA showed higher rates of peripheral disease and tender joint counts.
• Men with PsA exhibited a trend towards more axial disease and greater skin involvement.
• Women reported worse PROs, including pain and fatigue, and demonstrated poorer treatment responses (e.g., ACR responses, minimal disease activity).
• No significant sex differences were observed in Dermatology Life Quality Index scores.

Conclusions:

• Significant sex-specific differences exist in psoriatic arthritis presentation, disease activity, and treatment response.
• Current evidence highlights the need for further research to elucidate these disparities and inform sex-tailored management approaches.