Gender difference in disease severity and treatment outcomes among patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) treated for one year with certolizumab pegol - analysis from the nationwide ATTRA registry of biological therapy
Abstract
Introduction: The ATTRA registry captures more than 95% of patients with RA, AxSpA, or PSA treated with biologics in the Czech Republic (CZ). Objectives: We aimed to investigate gender-related differences in baseline characteristics and treatment effectiveness among patients with RA, AxSpa, and PsA starting first-line therapy with certolizumab pegol (CZP) in CZ.
Methods: In this observational cohort study, the ATTRA registry provided prospectively collected data on RA, AxSpA, and PsA patients who initiated first-line therapy with CZP TT in 2012-6/2018. Treatment effectiveness was assessed at 12 months by a change in patient-reported outcomes (PROs) and the laboratory marker CRP.
Differences in categorical and continuous data btw males and females were assessed using the Pearson χ2-test (of Fisher exact test, as appropriate), or Mann-Whitney test, respectively. This study was descriptive, and no statistical adjustments have been made.
Results: A total of 184 RA, 60 AxSpa, and 40 PsA patients were included. At the start of CZP treatment, men with RA and PsA had higher BMI and men with AxSpa had higher CRP than women; women with RA were more likely (current or former) smokers and had worse HAQ and EQ-5D scores, and women with AxSpa had higher fatigue scores than men.
The improvement in patients' quality of life assessed by the EQ-5D utility was higher in women with RA than in men after one year of CZP treatment. The fatigue score decreased more significantly in women with AxSpA than in men, while men with AxSpA showed a statistically more significant decrease in CRP than women.
Conclusions: CZP treatment had a similar, and in some aspects, even better effect on the quality of life in women with RA, AxSpA, and PsA after one year of follow-up compared to men.