Spondyloarthritis & psoriatic arthritis
Sex differences in patient-reported outcome measures and the association with clinical factors in axial spondyloarthritis patients treated with tumour necrosis factor inhibitors
Authors' conclusion
In axSpA patients initiating their first TNFi, baseline sex differences in BASDAI and BASFI increased two-fold after 6 months of treatment and persisted thereafter, with worse scores in women. Several baseline characteristics moderated the sex differences, though none could fully account for them.
Study context
- Population
- axSpA patients initiating their first TNFi, with ≥2 measurements of each analysed PROM, 15 EuroSpA registriesBASDAI analyses (38% women)
- Participants
- 13,102 patients
- Exposure
- Women vs men
- Outcome
- Sex differences in patient-reported outcome measures (PROMs) (BASDAI and BASFI, scale 0-100) over 24 months
- Follow-up
- 24 months
Methodological detailsregistry-based, 15 EuroSpA registries, multinational registry data, linear mixed models
- Registry-based, 15 EuroSpA registries
- Multinational registry data
- Linear mixed models
Main finding
As reported in the abstract
Mean sex difference in BASDAI (0-100), worse in women
Women vs MenMean difference, units (95% CI)
Baseline
4.3(3.5–5.1)
Women vs MenMean difference (95% CI)
6 months
8.0(7.2–8.8)
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (CI) | |
|---|---|---|
| Mean sex difference in BASFI (0-100), worse in womenWomenvs MenBaseline · consistently worse scores in women | 2.2 (1.4–3.1) | |
| Mean sex difference in BASFI (0-100), worse in womenWomenvs Men6 months · consistently worse scores in women | 4.6 (3.6–5.5) | |
| −50510Difference (linear scale) |
Baseline characteristics moderating sex differences
- Baseline characteristics could not substantially account for the observed sex differences over time
- Sex differences reduced by HLA-B27 positivity, longer disease duration and increased CRP
- Sex differences increased by TNFi initiation in later years and peripheral arthritis
Original publication
Sex differences in patient-reported outcome measures and the association with clinical factors in axial spondyloarthritis patients treated with tumour necrosis factor inhibitors. Rheumatology (Oxford). Published 23 July 2024. doi:10.
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