Spondyloarthritis & psoriatic arthritis
Effect of gender and age on bDMARD efficacy for axial spondyloarthritis patients: a meta-analysis of randomized controlled trials
Authors' conclusion
The bDMARDs were efficacious in all axSpA patients regardless of gender or age. However, the treatment responses were more evident in male and younger patients. Also, females with r-axSpA had greater responses than those with nr-axSpA, whereas no relevant difference was observed in males, indicating that the gender difference on efficacy was greater in nr-axSpA patients.
Study context
- Population
- Patients with axial SpA (axSpA) in RCTs of b/tsDMARDs (PubMed, Scopus, Embase, before 10 August 2023)
- Participants
- 4,127 patients9 studies
- Comparison
- bDMARDs vs placebo, by gender and age
- Outcome
- ASAS40 response
Methodological detailssubgroup analysis, Only one tsDMARD study met inclusion criteria and was excluded from further analysis
- Subgroup analysis
- Only one tsDMARD study met inclusion criteria and was excluded from further analysis
Pooled result
As reported in the abstract
ASAS40 response, bDMARDs vs placebo, by gender and age subgroup
bDMARDs vs PlaceboOdds ratio (95% CI)
Males
3.14(2.66–3.70)
Females
2.32(1.82–2.82)
Younger
4.00(2.50–6.40)
Older
2.21(1.15–4.22)
OR
- Efficacy more evident in males
- 1.89 (95% CI 1.56, 2.30)
- Efficacy more evident in younger patients
- 2.07 (95% CI 1.42, 3.02)
Further pooled results
Gender difference in efficacy by axSpA subtype (subgroup)
- Gender difference in efficacy more obvious in nr-axSpA
- P for heterogeneity = 0.03, I2 = 78.1%
- Males with r-axSpA and nr-axSpA shared similar responses
- P for heterogeneity = 0.87, I2 = 0%
- Females with r-axSpA showed greater response than those with nr-axSpA
- P for heterogeneity = 0.005, I2 = 87.4%
Original publication
Effect of gender and age on bDMARD efficacy for axial spondyloarthritis patients: a meta-analysis of randomized controlled trials. Rheumatology (Oxford). Published 6 February 2024. doi:10.
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