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A post-hoc analysis of three pooled randomized-controlled trials (RCTs) mapped sex differences in manifestations and outcomes of psoriatic arthritis (PsA). Women were generally older than men, had a longer PsA duration, a higher BMI, a higher prevalence of enthesitis, and less active psoriasis. Women also reported more fatigue, pain, and functional impairment.

In real-world evidence studies, women have worse composite joint disease activity scores and greater functional impairment than men, but generally less radiographic joint damage and milder psoriasis symptoms¹. To gain a better understanding of sex differences in PsA, sex-disaggregated baseline patient and disease profiles were described in a large cohort of 1,405 participants with active PsA from three phase 3 RCTs of guselkumab; 381 from DISCOVER-1 (NCT03162796), 739 from DISCOVER-2 (NCT03158285), and 285 from COSMOS (NCT03796858).

The main results were presented by Dr. Laura Coates, MBchB, PhD, from the University of Oxford, in the UK. She noted that there were no sex disparities in baseline disease activity or medication use among participants with highly active PsA. However, women tended to:

• Be older than men: mean age 48.2 versus 46.1 years (P<0.01).
• Have a longer disease duration: 6.9 versus 6.0 years (P<0.01).
• Have a higher BMI: 29.9 versus 28.8 (P<0.001).
• Have a higher prevalence of enthesitis: 70% versus 62% (P<0.01).
• Have less active psoriasis, e.g. a lower Psoriasis Area and Severity Index score: 7.8 versus 11.5 (P<0.0001).
• Report more fatigue, pain, and functional impairment.

Dr. Coates noted that sex differences in these RCT participants were consistent with findings from observational real-world cohorts. She concluded that the presented findings highlight the importance of considering biological sex and associated clinical features in the holistic management of patients with PsA.

Medical writing support was provided by Michiel Tent

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