Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study.
Journal
The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
accepted:
07
04
2021
pubmed:
11
4
2021
medline:
4
3
2022
entrez:
10
4
2021
Statut:
ppublish
Résumé
Few systematic data on sex-related treatment responses exist for psoriasis. To evaluate sex differences with respect to systemic antipsoriatic treatment. Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI ≤ 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) ≤ 1 and delta DLQI ≥ 4]. In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67·3% male, 69·8% female). Women showed slightly higher PASI response rates after 3 (54·8% vs. 47·2%; P ≤ 0·001), 6 (70·8% vs. 63·8%; P ≤ 0·001) and 12 months (72·3% vs. 66·1%; P ≤ 0·004). A significantly higher proportion of women achieved a reduction in DLQI ≥ 4 [month 3: 61·4% vs 54·8% (P ≤ 0·001); month 6: 69·6% vs. 62·4% (P ≤ 0·001); month 12: 70·7% vs. 64·4% (P ≤ 0·002)]. Regarding PASI ≤ 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57·8% vs. 48·5%; P ≤ 0·004) and 6 months (69·2% vs. 60·9%; P ≤ 0·018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI ≤ 3) over 12 months compared with men. We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.
Sections du résumé
BACKGROUND
Few systematic data on sex-related treatment responses exist for psoriasis.
OBJECTIVES
To evaluate sex differences with respect to systemic antipsoriatic treatment.
METHODS
Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI ≤ 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) ≤ 1 and delta DLQI ≥ 4].
RESULTS
In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67·3% male, 69·8% female). Women showed slightly higher PASI response rates after 3 (54·8% vs. 47·2%; P ≤ 0·001), 6 (70·8% vs. 63·8%; P ≤ 0·001) and 12 months (72·3% vs. 66·1%; P ≤ 0·004). A significantly higher proportion of women achieved a reduction in DLQI ≥ 4 [month 3: 61·4% vs 54·8% (P ≤ 0·001); month 6: 69·6% vs. 62·4% (P ≤ 0·001); month 12: 70·7% vs. 64·4% (P ≤ 0·002)]. Regarding PASI ≤ 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57·8% vs. 48·5%; P ≤ 0·004) and 6 months (69·2% vs. 60·9%; P ≤ 0·018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI ≤ 3) over 12 months compared with men.
CONCLUSIONS
We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.
Substances chimiques
Dermatologic Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1160-1168Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2021 British Association of Dermatologists.
Références
Hagg D, Sundstrom A, Eriksson M et al. Severity of psoriasis differs between men and women: a study of the clinical outcome measure Psoriasis Area and Severity Index (PASI) in 5438 Swedish register patients. Am J Clin Dermatol 2017; 18:583-90.
Augustin M, Reich K, Glaeske G et al. Co-morbidity and age-related prevalence of psoriasis: analysis of health insurance data in Germany. Acta Derm Venereol 2010; 90:147-51.
Augustin M, Herberger K, Hintzen S et al. Prevalence of skin lesions and need for treatment in a cohort of 90 880 workers. Br J Dermatol 2011; 165:865-73.
Maul JT, Djamei V, Kolios AGA et al. Efficacy and survival of systemic psoriasis treatments: an analysis of the Swiss registry SDNTT. Dermatology 2016; 232:640-7.
Jungo P, Maul JT, Djamei V et al. Superiority in quality of life improvement of biologics over conventional systemic drugs in a Swiss real-life psoriasis registry. Dermatology 2016; 232:655-63.
Maul JT, Navarini AA, Sommer R et al. Gender and age significantly determine patient needs and treatment goals in psoriasis - a lesson for practice. J Eur Acad Dermatol Venereol 2019; 33:700-8.
Merola JF, Wu S, Han J et al. Psoriasis, psoriatic arthritis and risk of gout in US men and women. Ann Rheum Dis 2015; 74:1495-500.
Cather JC. Psoriasis in children and women: addressing some special needs. Semin Cutan Med Surg 2014; 33 (2 Suppl. 2):S42-S44.
Bohm D, Stock Gissendanner S, Bangemann K et al. Perceived relationships between severity of psoriasis symptoms, gender, stigmatization and quality of life. J Eur Acad Dermatol Venereol 2013; 27:220-6.
Iskandar IYK, Warren RB, Lunt M et al. Differential drug survival of second-line biologic therapies in patients with psoriasis: observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol 2018; 138:775-84.
De Simone C, Caldarola G, Maiorino A et al. Clinical predictors of nonresponse to anti-TNF-alpha agents in psoriatic patients: a retrospective study. Dermatol Ther 2016; 29:372-6.
Gupta MA, Gupta AK. Age and gender differences in the impact of psoriasis on quality of life. Int J Dermatol 1995; 34:700-3.
Queiro R, Tejon P, Coto P et al. Clinical differences between men and women with psoriatic arthritis: relevance of the analysis of genes and polymorphisms in the major histocompatibility complex region and of the age at onset of psoriasis. Clin Dev Immunol 2013; 2013:482691.
Wilson FC, Icen M, Crowson CS et al. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum 2009; 61:233-9.
Augustin M, Spehr C, Radtke MA et al. German psoriasis registry PsoBest: objectives, methodology and baseline data. J Dtsch Dermatol Ges 2014; 12:48-57.
Muller D, Augustin M, Banik N et al. [Memorandum registry for health services research]. Gesundheitswesen 2010; 72:824-39 (in German).
Augustin M, Subcommission "Pharmacoeconomics and Quality of Life". [Recording of quality of life in dermatological studies. Guidelines of the Subcommission "Pharmacoeconomics and Quality of Life"]. Hautarzt 2001; 52:697-700 (in German).
Basra MK, Salek MS, Camilleri L et al. Determining the minimal clinically important difference and responsiveness of the Dermatology Life Quality Index (DLQI): further data. Dermatology 2015; 230:27-33.
Wan J, Abuabara K, Troxel AB et al. Dermatologist preferences for first-line therapy of moderate to severe psoriasis in healthy adult patients. J Am Acad Dermatol 2012; 66:376-86.
Nast A, Amelunxen L, Augustin M et al. S3 Guideline for the treatment of psoriasis vulgaris, update - Short version part 1 - Systemic treatment. J Dtsch Dermatol Ges 2018; 16:645-69.
Nast A, Amelunxen L, Augustin M et al. S3 Guideline for the treatment of psoriasis vulgaris, update - Short version part 2 - Special patient populations and treatment situations. J Dtsch Dermatol Ges 2018; 16:806-13.
de Fatima Bonolo P, Ceccato M, Rocha GM et al. Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy. Clinics (Sao Paulo) 2013; 68:612-20.
Tapp C, Milloy MJ, Kerr T et al. Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare. BMC Infect Dis 2011; 11:86.
Hadji P, Jacob L, Kostev K. Gender- and age-related treatment compliance in patients with osteoporosis in Germany. Patient Prefer Adherence 2016; 10:2379-85.
Lesuis N, Befrits R, Nyberg F et al. Gender and the treatment of immune-mediated chronic inflammatory diseases: rheumatoid arthritis, inflammatory bowel disease and psoriasis: an observational study. BMC Med 2012; 10:82.