Gender difference in disease expression, radiographic damage and disability among patients with psoriatic arthritis

Eder, Lihi; Thavaneswaran, Arane; Chandran, Vinod; Gladman, Dafna D.

doi:10.1136/annrheumdis-2012-201357

Cited by 102 publications

(95 citation statements)

References 35 publications

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“…Women report more frequent peripheral joint involvement and more functional disability, whereas the male gender is associated with axial involvement and more severe radiographic damage. [7,8] It is important to consider that the clear definition of axial involvement in PsA is still a matter of discussion. [9] Different proposals have been considered, such as unilateral/asymmetrical sacroiliitis, presence of syndesmophytes, and inflammatory back pain in association with limited movement of the spine.…”

Section: Introductionmentioning

confidence: 99%

Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

et al. 2016

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The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X2 or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P < 0.05), although no difference was observed in psoriatic or IBD spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

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Section: Introductionmentioning

confidence: 99%

Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

et al. 2016

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“…However, the therapeutic approaches were not analyzed from a gender point of view. Since then, many differences have been reported between genders in psoriatic patients, in terms of epidemiology (4), pattern and burden of disease (5), search for care (6), and choice of therapy (7,8). Thus, the large cohort of patients provided by the PSYCHAE study database offered a great opportunity to explore the gender-specific therapeutic approaches adopted by the 39 Italian dermatologic centers participating in the study.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic approaches in psoriasis: a post-hoc analysis of the PSYCHAE study from a gender point of view

Colombo¹

2014

CDERM

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SummaryPSYCHAE was a multicenter observational study conducted in [2004][2005], which included 1580 psoriatic patients. We performed a post-hoc analysis to explore gender differences and the gender-specific therapeutic approaches adopted by Italian dermatologists. Type, severity and duration of psoriasis, presence of psoriatic arthritis, General Health Questionnaire score, Brief COPE questionnaire, Brief Symptom Inventory indexes and prescribed therapies were compared between genders. 786 patients were evaluable for the analysis, 477 (61%) males. Highly significant differences were found in frequency of alcohol consumption and of smokers, which were higher in men, and in GHQ-12 and all BSI scores, which were all significantly worse in women at baseline. Other significant differences were familiarity for psoriasis or arthritis (higher in women), and severity of psoriasis (higher in men). Topical pharmacological therapy was the most prescribed treatment in both genders and no significant differences were observed in prescribed therapies, except for phototherapy (37% of males vs 29% of females; p=0.0121). With the major limitation of referring to a cohort studied in 2004-2005, when biologicals were not used yet for psoriasis, this analysis shows that, at that time, Italian dermatologists seemed to have the same approach in treating male and female patients with psoriasis, although females should have deserved more attention to their higher psychological distress.

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“…Men have been found to experience more severe and extensive psoriasis than women (21), which might result in a greater recognition of paternal skin disease among children of PsC males and a greater likelihood that they would participate in a study. Similarly, women with PsA report more severe limitations in function and worse quality of life than men (6), which could result in higher recognition of a woman's joint disease among her family members, and a greater likelihood that children of PsA females would participate. Furthermore, the accuracy of the self-reported family history used in this study depends on the proband's ability to discriminate between affected and unaffected relatives.…”

Section: Discussionmentioning

confidence: 99%

“…Psoriasis and PsA are thought to result from an interplay of environmental and genetic risk factors related to skin and joint disease (3)(4)(5). Psoriasis and PsA affect men and women equally, although disease expression differs between the sexes, with men developing more axial disease and radiographic damage, and women developing more peripheral polyarthritis (6). However, intriguingly, there is a differential pathogenicity and expression of psoriatic disease that depends on the sex of the disease-transmitting parent.…”

Section: Introductionmentioning

confidence: 99%

Further Evidence Supporting a Parent‐of‐Origin Effect in Psoriatic Disease

Pollock

Thavaneswaran

Pellett

et al. 2015

Arthritis Care & Research

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ObjectiveTo further explore the “parent‐of‐origin” effect in a large cohort of well‐phenotyped patients with cutaneous psoriasis without arthritis (PsC) and psoriatic arthritis (PsA).MethodsSelf‐reported family history was obtained from PsA patients from Toronto and Newfoundland satisfying the Classification of Psoriatic Arthritis criteria, and PsC patients from Toronto, who were examined by a rheumatologist to exclude PsA. Proportions of probands with paternally and maternally transmitted psoriatic disease were compared by McNemar's and chi‐square tests. Baseline clinical and genetic characteristics of probands with paternally and maternally transmitted disease were compared using logistic regression.ResultsA total of 849 probands reported a first‐degree relative affected with psoriatic disease (PsC or PsA), of which 532 (63%) reported an affected parent. A significantly larger proportion of probands reported an affected father compared to an affected mother with psoriatic disease (289 [57%] versus 220 [43%], respectively; P = 0.003). This paternal transmission bias was evident in PsA (P = 0.006) and PsC probands, although it did not reach statistical significance in PsC probands (P = 0.20). Furthermore, the proportion of paternal PsC–proband PsA pairs (161 of 214 paternal transmissions [75%]) was significantly larger than maternal PsC–proband PsA pairs (103 of 161 maternal transmissions [64%]) (P = 0.02). Newfoundland probands with paternally transmitted disease had higher HLA–B*08 carriage (P = 0.04) and lower MICA–129Met carriage (P = 0.03). Males had higher HLA–B*38 carriage (P = 0.05) and a higher prevalence of nail lesions (P = 0.01).ConclusionWe have provided further epidemiologic evidence of a paternal transmission bias in psoriatic disease.

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Gender difference in disease expression, radiographic damage and disability among patients with psoriatic arthritis

Abstract: Men with PsA are more likely to develop axial involvement and radiographic joint damage, while women are more likely to report about limitation in function and impaired quality of life.

Cited by 102 publications

References 35 publications

Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

Therapeutic approaches in psoriasis: a post-hoc analysis of the PSYCHAE study from a gender point of view

Further Evidence Supporting a Parent‐of‐Origin Effect in Psoriatic Disease

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