https://doi.org/10.4081/reumatismo.2024.1779
Gender differences in clinical features and quality of life of patients with axial spondyloarthritis and psoriatic arthritis
Published: 11 September 2024
Abstract Views: 952
PDF: 168
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective. The aim of the current study was to compare the clinical and treatment characteristics and dimensions of health-related quality of life between female and male patients with axial spondyloarthritis (SpA) and psoriatic arthritis (PsA).
Methods. The present study is cross-sectional and comprises 119 patients with axial SpA and 198 patients with PsA. Clinical data were collected by standardized and self-reported instruments. Disease activity was evaluated by the Ankylosing Spondylitis Disease Activity Score with C-reactive protein and the Disease Activity in PSoriatic Arthritis (for SpA and PsA, respectively). Health-related quality of life was assessed with the Medical Outcomes Study 36-item Short Form Survey. Patients were stratified by gender, and the socio-demographic, clinical, and quality-of-life data were compared.
Results. Women with axial SpA and PsA had significantly lower education (p<0.001, p=0.004, respectively) and higher disease activity (p<0.001, p=0.003, respectively). Female patients with axial SpA were more frequently under second-line therapy (p=0.026) and glucocorticoid treatment (p=0.005), while women with PsA had more radiographic progression (p=0.006). Female patients with axial SpA and PsA had worse scores in the dimensions of quality of life regarding physical role, bodily pain, vitality, and mental health. Women with axial SpA had lower scores in general health, while women with PsA had lower scores in physical and social functioning.
Conclusions. Women with axial SpA and PsA had worse scores than men in most clinical and treatment characteristics and health-related quality of life dimensions.
Legato MJ, Johnson PA, Manson JE. Consideration of sex differences in medicine to improve health care and patient outcomes. JAMA 2016; 316: 1865-6.
DOI: https://doi.org/10.1001/jama.2016.13995
Cirillo D, Catuara-Solarz S, Morey C, Guney E, Subirats L, Mellino S, et al. Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare. NPJ Digit Med 2020; 3: 81.
DOI: https://doi.org/10.1038/s41746-020-0288-5
Stovall R, van der Horst-Bruinsma IE, Liu SH, Rusman T, Gensler LS. Sexual dimorphism in the prevalence, manifestation and outcomes of axial spondyloarthritis. Nat Rev Rheumatol 2022; 18: 657-69.
DOI: https://doi.org/10.1038/s41584-022-00833-0
Tarannum S, Leung YY, Johnson SR, Widdifield J, Strand V, Rochon P, et al. Sex- and gender-related differences in psoriatic arthritis. Nat Rev Rheumatol 2022; 18: 513-26.
DOI: https://doi.org/10.1038/s41584-022-00810-7
Rusman T, van Bentum RE, van der Horst-Bruinsma IE. Sex and gender differences in axial spondyloarthritis: myths and truths. Rheumatology 2020; 59: iv38-46.
DOI: https://doi.org/10.1093/rheumatology/keaa543
Lubrano E, Scriffignano S, Fatica M, Triggianese P, Conigliaro P, Perrotta FM, et al. Psoriatic arthritis in males and females: differences and similarities. Rheumatol Ther 2023; 10: 589-99.
DOI: https://doi.org/10.1007/s40744-023-00535-3
Nas K, Kiliç E, Tekeoğlu İ, Keskin Y, Çevik R, Sargin B, et al. The effect of gender on disease activity and clinical characteristics in patients with axial psoriatic arthritis. Mod Rheumatol 2021; 31: 869-74.
DOI: https://doi.org/10.1080/14397595.2020.1812870
Braaten TJ, Zhang C, Presson AP, Breviu B, Clegg D, Walsh JA. Gender differences in psoriatic arthritis with fatigue, pain, function, and work disability. JPPA 2019; 4: 192-7.
DOI: https://doi.org/10.1177/2475530319870776
Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics 2016; 34: 645-9.
DOI: https://doi.org/10.1007/s40273-016-0389-9
Yang X, Fan D, Xia Q, Wang M, Zhang X, Li X, et al. The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Qual Life Res 2016; 25: 2711-23.
DOI: https://doi.org/10.1007/s11136-016-1345-z
Law L, Beckman Rehnman J, Deminger A, Klingberg E, Jacobsson LTH, Forsblad-d'Elia H. Factors related to health-related quality of life in ankylosing spondylitis, overall and stratified by sex. Arthritis Res Ther 2018; 20: 284.
DOI: https://doi.org/10.1186/s13075-018-1784-8
Webers C, Essers I, Ramiro S, Stolwijk C, Landewé R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology 2016; 55: 419-28.
DOI: https://doi.org/10.1093/rheumatology/kev340
Enginar A. A comparison of the clinical characteristics and quality of life of male and female patients with non-radiographic axial spondyloarthritis. Int Immunopharmacol 2023; 123: 110627.
DOI: https://doi.org/10.1016/j.intimp.2023.110627
Neuenschwander R, Hebeisen M, Micheroli R, Bürki K, Exer P, Niedermann K, et al. Differences between men and women with nonradiographic axial spondyloarthritis: clinical characteristics and treatment effectiveness in a real-life prospective cohort. Arthritis Res Ther 2020; 22: 233.
DOI: https://doi.org/10.1186/s13075-020-02337-2
Andreasen RA, Kristensen LE, Egstrup K, Baraliakos X, Strand V, Horn HC, et al. The impact of sex and disease classification on patient-reported outcome measures in axial spondyloarthritis: a descriptive prospective cross-sectional study. Arthritis Res Ther 2019; 21: 221.
DOI: https://doi.org/10.1186/s13075-019-2012-x
de Carvalho HM, Bortoluzzo AB, Gonçalves CR, Braga da Silva JA, Ximenes AC, Bértolo MB, et al. Gender characterization in a large series of Brazilian patients with spondyloarthritis. Clin Rheumatol 2012; 31: 687-95.
DOI: https://doi.org/10.1007/s10067-011-1890-3
Marzo-Ortega H, Navarro-Compán V, Akar S, Kiltz U, Clark Z, Nikiphorou E. The impact of gender and sex on diagnosis, treatment outcomes and health-related quality of life in patients with axial spondyloarthritis. Clin Rheumatol 2022; 41: 3573-81.
DOI: https://doi.org/10.1007/s10067-022-06228-6
Husted JA, Gladman DD, Farewell VT, Cook RJ. Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Arthritis Rheum 2001; 45: 151-8.
DOI: https://doi.org/10.1002/1529-0131(200104)45:2<151::AID-ANR168>3.3.CO;2-K
Eder L, Chandran V, Gladman DD. Gender-related differences in patients with psoriatic arthritis. Int J Clin Rheumatol 2012; 7: 641-9.
DOI: https://doi.org/10.2217/ijr.12.63
Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The assessment of spondyloarthritis international society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 2009; 68: ii1-44.
DOI: https://doi.org/10.1136/ard.2008.104018
Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-73.
DOI: https://doi.org/10.1002/art.21972
Pezzato S, Bonetto C, Caimmi C, Tomassi S, Montanari I, Gnatta MG, et al. Depression is associated with increased disease activity and higher disability in a large Italian cohort of patients with rheumatoid arthritis. Adv Rheumatol 2021; 61: 57.
DOI: https://doi.org/10.1186/s42358-021-00214-3
Tosato S, Bonetto C, Zanini A, Montanari I, Piccinelli A, Bixio R, et al. Coping strategies, emotional distress and perceived disease severity in a cohort of patients with rheumatoid arthritis: a mediation analysis. Rheumatology 2023; 62: 1078-86.
DOI: https://doi.org/10.1093/rheumatology/keac445
Ristic B, Carletto A, Fracassi E, Pacenza G, Zanetti G, Pistillo F, et al. Comparison and potential determinants of health-related quality of life among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: a cross-sectional study. J Psychosom Res 2023; 175: 111512.
DOI: https://doi.org/10.1016/j.jpsychores.2023.111512
Machado PM, Landewé RB, van der Heijde DM. Endorsement of definitions of disease activity states and improvement scores for the ankylosing spondylitis disease activity score: results from OMERACT 10. J Rheumatol 2011; 38: 1502-6.
DOI: https://doi.org/10.3899/jrheum.110279
Smolen JS, Schoels M, Aletaha D. Disease activity and response assessment in psoriatic arthritis using the disease activity index for psoriatic arthritis (DAPSA). A brief review. Clin Exp Rheumatol 2015; 33: S48-50.
Tosato S, Bonetto C, Zanini A, Bixio R, Marchel M, Pacenza G, et al. Clinical and psychological characteristics associated with negative beliefs and concerns about treatment necessity in rheumatic diseases. Sci Rep 2022; 12: 22603.
DOI: https://doi.org/10.1038/s41598-022-27046-5
Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol 1998; 51: 1025-36.
DOI: https://doi.org/10.1016/S0895-4356(98)00094-8
Ware JE Jr. SF-36 health survey update. Spine (Phila Pa 1976) 2000; 25: 3130-9.
DOI: https://doi.org/10.1097/00007632-200012150-00008
Kwan YH, Fong WW, Lui NL, Yong ST, Cheung YB, Malotra R, et al. Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore. Rheumatol Int 2016; 36: 1759-65.
DOI: https://doi.org/10.1007/s00296-016-3567-3
Husted JA, Gladman DD, Farewell VT, Long JA, Cook RJ. Validating the SF-36 health survey questionnaire in patients with psoriatic arthritis. J Rheumatol 1997; 24: 511-7.
Nam B, Koo BS, Nam SW, Shin JH, Song Y, Cho SK, et al. Gender differences in factors associated with low quality of life and depression in Korean patients with ankylosing spondylitis. Qual Life Res 2021; 30: 2299-310.
DOI: https://doi.org/10.1007/s11136-021-02800-w
Nas K, Capkin E, Dagli AZ, Cevik R, Kilic E, Kilic G, et al. Gender specific differences in patients with psoriatic arthritis. Mod Rheumatol 2017; 27: 345-9.
DOI: https://doi.org/10.1080/14397595.2016.1193105
Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort. Arthritis Care Res 2013; 65: 1482-9.
DOI: https://doi.org/10.1002/acr.22001
Wright GC, Kaine J, Deodhar A. Understanding differences between men and women with axial spondyloarthritis. Semin Arthritis Rheum 2020; 50: 687-94.
DOI: https://doi.org/10.1016/j.semarthrit.2020.05.005
Lee W, Reveille JD, Davis JC Jr, Learch TJ, Ward MM, Weisman MH. Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis 2007; 66: 633-8.
DOI: https://doi.org/10.1136/ard.2006.060293
Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis 2023; 82: 19-34.
DOI: https://doi.org/10.1136/ard-2022-223296
Wallenius M, Skomsvoll JF, Koldingsnes W, Rødevand E, Mikkelsen K, Kaufmann C, et al. Work disability and health-related quality of life in males and females with psoriatic arthritis. Ann Rheum Dis 2009; 68: 685-9.
DOI: https://doi.org/10.1136/ard.2008.092049
Leung YY, Tam LS, Kun EW, Ho KW, Li EK. Comparison of 4 functional indexes in psoriatic arthritis with axial or peripheral disease subgroups using Rasch analyses. J Rheumatol 2008; 35: 1613-21.
Lim WZ, Fong W, Kwan YH, Leung YY. Exploring the prevalence and factors associated with fatigue in axial spondyloarthritis in an Asian cohort in Singapore. Front Med 2021; 8: 603941.
DOI: https://doi.org/10.3389/fmed.2021.603941
Tan JSQ, Fong W, Kwan YH, Leung YY. Prevalence and variables associated with fatigue in psoriatic arthritis: a cross-sectional study. Rheumatol Int 2020; 40: 1825-34.
DOI: https://doi.org/10.1007/s00296-020-04678-2
Park JY, Howren AM, Zusman EZ, Esdaile JM, De Vera MA. The incidence of depression and anxiety in patients with ankylosing spondylitis: a systematic review and meta-analysis. BMC Rheumatol 2020; 4: 12.
DOI: https://doi.org/10.1186/s41927-019-0111-6
Hong C, Kwan YH, Leung YY, Lui NL, Fong W. Comparison of ankylosing spondylitis and non-radiographic axial spondyloarthritis in a multi-ethnic Asian population of Singapore. Int J Rheum Dis 2019; 22: 1506-11.
DOI: https://doi.org/10.1111/1756-185X.13603
Mease PJ. Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res 2011; 63: S64-85.
DOI: https://doi.org/10.1002/acr.20577
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191-4.
DOI: https://doi.org/10.1001/jama.2013.281053
How to Cite
Ristic, B., Bonetto, C., Rossini, M., Fracassi, E., Carletto, A., & Tosato, S. (2024). Gender differences in clinical features and quality of life of patients with axial spondyloarthritis and psoriatic arthritis. Reumatismo, 76(3). https://doi.org/10.4081/reumatismo.2024.1779
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- Y. Emad, T. Gheita, H. Darweesh, P. Klooster, R. Gamal, H. Fathi, N. El-Shaarawy, M. Gamil, M. Hawass, R.M. El-Refai, H. Al-Hanafi, S. Abd-Ellatif, A. Ismail, J. Rasker, Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus patients: correlations with clinical manifestations and disease activity , Reumatismo: Vol. 70 No. 2 (2018)
- M. Capraro, M. Dalla Valle, M. Podswiadek, P. De Sandre, E. Sgnaolin, R. Ferrari, The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions , Reumatismo: Vol. 64 No. 3 (2012)
- F.M. Perrotta, E. Lubrano, New approved drugs for psoriatic arthritis , Reumatismo: Vol. 68 No. 2 (2016)
- M. Romano, I. Pontikaki, M. Gattinara, I. Ardoino, C. Donati, P. Boracchi, P.L. Meroni, V. Gerloni, Drug survival and reasons for discontinuation of the first course of biological therapy in 301 juvenile idiopathic arthritis patients , Reumatismo: Vol. 65 No. 6 (2013)
- M. Rossini, G. D'Avola, M. Muratore, N. Malavolta, F. Silveri, G. Bianchi, B. Frediani, G. Minisola, M. L. Sorgi, M. Varenna, R. Foti, G. Tartarelli, G. Orsolini, S. Adami, Regional differences of vitamin D deficiency in rheumatoid arthritis patients in Italy , Reumatismo: Vol. 65 No. 3 (2013)
- G. Lapadula, A. Marchesoni, F. Salaffi, R. Ramonda, C. Salvarani, L. Punzi, L. Costa, F. Caso, D. Simone, G. Baiocchi, C. Scioscia, M. Di Carlo, R. Scarpa, G. Ferraccioli, Evidence-based algorithm for diagnosis and assessment in psoriatic arthritis: results by Italian DElphi in psoriatic Arthritis (IDEA) , Reumatismo: Vol. 68 No. 3 (2016)
- S.L. Bello, L. Serafino, C. Bonali, N. Terlizzi, C. Fanizza, C. Anecchino, G. Lapaldula, Incidence of influenza-like illness into a cohort of patients affected by chronic inflammatory rheumatism and treated with biological agents , Reumatismo: Vol. 64 No. 5 (2012)
- S. Canestri, M.C. Totaro, E. Serone, B. Tolusso, D. Frezza, E. Gremese, G. Ferraccioli, Association between the response to B cell depletion therapy and the allele*2 of the HS1,2A enhancer in seropositive rheumatoid arthritis patients , Reumatismo: Vol. 64 No. 6 (2012)
- E. Cipriano, F. Ceccarelli, L. Massaro, F. R. Spinelli, C. Alessandri, C. Perricone, G. Valesini, F. Conti, Joint involvement in patients affected by systemic lupus erythematosus: application of the swollen to tender joint count ratio , Reumatismo: Vol. 67 No. 2 (2015)
- A. Marino, I. Pagnini, S. Savelli, D. Moretti, G. Simonini, R. Cimaz, Elbow monoarthritis: an atypical onset of juvenile idiopathic arthritis , Reumatismo: Vol. 64 No. 3 (2012)
You may also start an advanced similarity search for this article.
