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Sex differences in patient-reported outcome measures and the association with clinical factors in axial spondyloarthritis patients treated with tumour necrosis factor inhibitors
P. Hellamand, MGH. van de Sande, MT. Nurmohamed, RF. van Vollenhoven, RJ. Hollick, O. Rotariu, Z. Rotar, KP. Pirkmajer, D. Nordström, AM. Hokkanen, B. Michelsen, TK. Kvien, B. Glintborg, ML. Hetland, M. Østergaard, AG. Loft, K. Pavelka, J....
Language English
Document type Journal Article
Grant support
The EuroSpA Research Collaboration Network
Novartis Pharma AG
AbbVie
AstraZeneca
Centre for Clinical Treatment Research
The Research Council of Norway
- MeSH
- Antirheumatic Agents * therapeutic use MeSH
- Axial Spondyloarthritis * drug therapy MeSH
- Adult MeSH
- Patient Reported Outcome Measures * MeSH
- Tumor Necrosis Factor Inhibitors * therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Registries MeSH
- Sex Factors MeSH
- Severity of Illness Index MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: To investigate sex differences in patient-reported outcome measures (PROMs) among axSpA patients initiating their first TNFi and identify factors contributing to these disparities over the follow-up. METHODS: Data were included from 15 EuroSpA registries and consisted of axSpA patients initiating their first TNFi, with ≥2 measurements for each analysed PROM (BASDAI and BASFI, scale 0-100) taken at any time point. Linear mixed models were employed to analyse sex differences in PROMs over 24 months and to evaluate how baseline characteristics were related to the observed sex differences. RESULTS: We analysed 13 102 (38% women) in the BASDAI analyses and 10 623 (38% women) in the BASFI analyses. At follow-up, mean sex differences in BASDAI increased from 4.3 units at baseline (95% CI, 3.5-5.1) to 8.0 (7.2-8.8) at 6 months, and in BASFI from 2.2 (1.4-3.1) to 4.6 (3.6-5.5), with consistently worse scores in women. Baseline characteristics could not substantially account for the observed sex differences over time; however, the magnitude of the sex differences was reduced by HLA-B27 positivity, longer disease duration, and increased CRP levels, but increased by TNFi initiation in later years and peripheral arthritis. 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. These findings improve our understanding of sex differences and underscore their importance in axSpA.
Aberdeen Centre for Arthritis and Musculoskeletal Health University of Aberdeen Aberdeen UK
Amsterdam Rheumatology and Immunology Center Amsterdam Netherlands
Amsterdam Rheumatology and Immunology Center Reade and Amsterdam UMC Amsterdam Netherlands
Center for Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania
Center for Treatment of Rheumatic and Musculoskeletal Diseases Diakonhjemmet Hospital Oslo Norway
Centre for Rheumatology Research Landspitali University Hospital Reykjavik Iceland
DANBIO and Department of Rheumatology Aarhus University Hospital Aarhus Denmark
Department of Clinical Immunology and Rheumatology Amsterdam UMC Location AMC Netherlands Amsterdam
Department of Clinical Medicine Aarhus University Aarhus Denmark
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Epidemiology and Data Science Amsterdam UMC Amsterdam Netherlands
Department of Medicine Helsinki University and Helsinki University Hospital Helsinki Finland
Department of Medicine Surgery and Neurosciences Rheumatology Unit University of Siena Siena Italy
Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Rheumatology Geneva University Hospital Geneva Switzerland
Department of Rheumatology Hospital General Universitario Gregorio Marañón Madrid Spain
Department of Rheumatology Radboud University Medical Center Nijmegen Netherlands
Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland
Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia
Departments of Medicine and Rheumatology Helsinki University Hospital Helsinki Finland
Faculty of Medicine Complutense University of Madrid Madrid Spain
Faculty of Medicine University of Iceland Reykjavik Iceland
Faculty of Medicine University of Ljubljana Ljubljana Slovenia
Institute of Rheumatology Prague Czech Republic
Research Unit Sørlandet Hospital Kristiansand Norway
Research Unit Spanish Society of Rheumatology Madrid Spain
Reuma pt and Department of Rheumatology Hospital Garcia de Orta Almada Portugal
References provided by Crossref.org
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