The Difference Gender Makes in Psoriatic Arthritis

The impact of psoriatic arthritis (PsA) differs widely between genders, several studies show.

In the most recent research, published online in Modern Rheumatology last month, found that disease activity, physical disability, functional limitation, depression and anxiety scores were higher among women with PsA than amone men with the disease. The researchers reported that quality of life and Psoriasis Area and Severity Index (PASI) scores were higher in male patients.

The study of more than 1,000 patients with PsA at 25 centers in Turkey zeroed in on patients with “axial” PsA, a recognized categorization of PsA that means the disease affects the spine, hips and shoulders in contrast to the “peripheral” PsA, which affects the arms and legs).

Pain score, fatigue, quality of life, anxiety, depression, and other scores were significantly worse in females than males with axial PsA. However, quality of life was better and PASI scores were worse in men than in women, the research team led by Kemal Nas of Sakarya University.

“This study has shown that the burden of disease in axial PsA has significant difference between genders. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients,” wrote Nas and his colleagues.

Kemal Nas

Nas was the lead author of a previous study exploring gender differences among people with PsA that was also published in Modern Rheumatology. That 2017 study found that women with PsA had higher symptom duration and body-mass indexes than men with the disease.

“Men with PsA are more likely to have higher PASI scores and longer duration to develop arthritis after the onset of psoriasis, while women are more likely to have higher disease activity and report more fatigue and physical activity limitations,” says the abstract.

Not all of Nas’ findings have pointed to differences between the sexes. In the 2017 study, for example, Nas and his colleagues found that that quality of life, extra-articular features (including uveitis and iritis), family history of PsA and the rates of spondyloarthritis and ankylosing spondylitis were very similar among both men and women.