Spondyloarthritis & psoriatic arthritis
Sex-related differences in patient characteristics, and efficacy and safety of advanced therapies in randomised clinical trials in psoriatic arthritis: a systematic literature review and meta-analysis
Authors' conclusion
Biological sex of patients with psoriatic arthritis influences their response to advanced therapies, but the effect varies by drug class.
Study context
- Population
- Participants in RCTs assessing the efficacy of advanced therapies (biological and targeted synthetic) in PsA
- Participants
- 22,621 participants54 trials
- Comparison
- Male vs female patients with PsA in RCTs of advanced therapies, by drug class
- Malen = 11,107
- Femalen = 11,514reference
- Outcome
- ACR20, ACR50 and minimal disease activity (MDA) response in male vs female patients by drug class
Methodological detailsrandom-effects models, Risk of bias was low for most studies
- Random-effects models
- Risk of bias was low for most studies
Pooled result
As reported in the abstract
ACR20 response, male vs female, by drug class
Male vs FemaleOdds ratio (95% CI)
IL-17 inhibitors
1.70(1.38–2.11)
IL-23 inhibitor
1.46(1.20–1.78)
IL-12 and IL-23 inhibitor
2.67(1.39–5.09)
TNF inhibitors
1.55(1.11–2.18)
JAK and TYK2 inhibitors; no difference
1.10(0.87–1.38)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| ACR50 response, male vs female, by drug classMalevs FemaleTNF inhibitors | 2.17 (1.62–2.90) | |
| ACR50 response, male vs female, by drug classMalevs FemaleIL-17 inhibitors | 1.93 (1.56–2.38) | |
| ACR50 response, male vs female, by drug classMalevs FemaleIL-23 inhibitor | 1.71 (1.25–2.34) | |
| ACR50 response, male vs female, by drug classMalevs FemaleIL-12 and 23 inhibitor | 2.43 (1.14–5.20) | |
| ACR50 response, male vs female, by drug classMalevs FemaleJAK and TYK2 inhibitors | 1.09 (0.73–1.62) | |
| MDA, male vs female, by drug classMalevs FemaleIL-17 inhibitors | 1.99 (1.50–2.63) | |
| MDA, male vs female, by drug classMalevs FemaleIL-23 inhibitors | 1.79 (1.29–2.50) | |
| MDA, male vs female, by drug classMalevs FemaleTNF inhibitors | 2.62 (1.54–4.44) | |
| MDA, male vs female, by drug classMalevs FemaleJAK and TYK2 inhibitors | 1.77 (1.15–2.73) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Mean difference (95% CI) | |
|---|---|---|
| Baseline characteristics, male vs femaleMalevs FemaleTender joint count | −3.01 (−3.83 to −2.18) | |
| Baseline characteristics, male vs femaleMalevs FemaleHAQ scores | −0.28 (−0.33 to −0.24) | |
| Baseline characteristics, male vs femaleMalevs FemalePain scores | −4.58 (−6.86 to −2.30) | |
| Baseline characteristics, male vs femaleMalevs FemalePGA (patient) | −3.22 (−5.27 to −1.17) | |
| Baseline characteristics, male vs femaleMalevs FemalePhysician global assessment | −1.34 (−2.08 to −0.08) | |
| Baseline characteristics, male vs femaleMalevs FemalePASI scores | 1.95 (0.78–3.11) | |
| Baseline characteristics, male vs femaleMalevs FemaleCRP concentrations | 2.57 (0.40–4.74) | |
| −10−505Difference (linear scale) |
Sex-disaggregated reporting
- Baseline characteristics reported by sex
- nine [17%] of 54
- Efficacy reported by sex
- 18 [33%]
- Safety endpoints reported by sex
- two [4%]
Original publication
Sex-related differences in patient characteristics, and efficacy and safety of advanced therapies in randomised clinical trials in psoriatic arthritis: a systematic literature review and meta-analysis. Lancet Rheumatol. Published 14 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →