Dr Eder reviews research she and colleagues conducted into how women and men respond differently to advanced therapies for psoriatic arthritis.

Lihi Eder, MD, is a rheumatologist and associate professor of medicine at the University of Toronto in Toronto, Ontario, Canada.

TRANSCRIPT:

Hello everyone, my name is LihI Eder, I'm a rheumatologist and associate professor from the University of Toronto in Canada, and I'll be reporting about a study that we presented as an oral presentation here at the ACR meeting in San Diego. The study aimed to assess whether men and women respond differently to advanced therapy among patients with psoriatic arthritis.

So the reason we did this study, we know that there are differences in clinical presentation between men and women with PSA, and women tend to have more pain and lower quality of life. There are also some observational studies, particularly in TNF inhibitors, that show inferior response of women and the fact that women tend to discontinue treatment earlier than men. We don't know what the reasons for that, and we also have very limited information on data from randomised control trials in psoriatic arthritis about these sex differences.

So we've performed a systematic literature review and meta-analysis of trials of advanced therapies in patients with psoriatic arthritis, and we aim to compare efficacy and safety endpoints in these patients. So overall we identified 54 trials of advanced therapies in patients with psoriatic arthritis. We identified 18 trials that did report ACR20 response by sex, and among these trials we found that overall when we looked at the chances of achieving this outcome, males had higher chances of achieving ACR response. But when we looked at different classes of medications, there were significant differences between biologic and targeted synthetic DMARDs, where all of the biologics, including TNF inhibitors, IL-17 inhibitors, IL-12/23 inhibitors, and IL-23 inhibitors, all of them show favorable response or higher chances of achieving ACR20 in male patients compared to female patients.

But when we looked at JAK-TYK2 inhibitors, there was absolutely no difference between males and females, and this suggests that maybe there is some kind of a class effect in terms of the effect. Because this was a meta-analysis and we didn't have patient level data, we could not really investigate what were the mechanisms behind these differential response across sexes, but it really highlights the fact that there might be some biological differences, whether it's the immune system or production of autoantibodies or pharmacokinetics of drugs or other things that suggest that men and women might respond differently to different agents, and we may need to be taking that into consideration in the future once we understand more of the mechanisms. For more information visit www.ncbi.nlm.nih.gov