Inflammatory Arthritis Disease Burden Differs in Men and Women

An observational study of patients with inflammatory arthritis treated with tumor necrosis factor inhibitors (TNFi) revealed that a lower proportion of women, compared with men, were in remission and experienced more significant symptoms.

Researchers published their findings online in PLOS One.

“We believe that our study may raise awareness [of] the sex gap in reporting of clinical data, where more focus on women is warranted, to ensure better tailoring of treatment and follow-up also for women,” researchers wrote.

The study included 305 adults — 167 men and 138 women — treated with TNFis at a hospital in Norway for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. Researchers compared a wide range of measures of inflammatory arthritis burden among male and female patients.

Just 45% of women were in remission per disease-specific composite scores compared with 59% of men, according to the study. Women had significantly worse scores for pain, joint pain, fatigue, enthesitis, physical functioning, vitality, and social functioning. Women also reported more activity impairment and missed work time than men.

TNFi trough levels, neutralizing antibodies, and calprotectin were similar between men and women, the study showed.

Total number of comorbidities, too, were similar. However, hypothyroidism was reported more frequently by women, and 10-year calculated risk of fatal cardiovascular events was higher in men.

“Our study highlights that clinicians should be aware of sex differences when interpreting clinical outcomes and treatment responses in inflammatory arthritis patients,” researchers wrote, “especially when it comes to differences in perception of symptoms, e.g. pain and fatigue.”

—Jolynn Tumolo

Reference:
Michelsen B, Berget KT, Loge JH, Kavanaugh A, Haugeberg G. Sex difference in disease burden of inflammatory arthritis patients treated with tumor necrosis factor inhibitors as part of standard care. PLoS One. 2022;17(5):e0266816.