Survey Showcases Gender Perceptions on PsA, Women Seen as Suffering More

Lihi Eder

Credit: Women's College Hospital

A survey revealed females with psoriatic arthritis (PsA) have a larger PsA burden with greater reports of tender joints, patches of flaking or red skin, and tenderness or swelling between muscles and bones, compared to their male counterparts.¹

“These findings are consistent with studies showing that enthesitis was worse in females than males, as were tender joint counts,” investigators wrote, led by Lihi Eder, from the division of rheumatology at Women’s College Research Institute, University of Toronto.

PsA, a long-term illness, can cause damage to joints and problems with skin and nails. Psoriasis occurs in a similar number of males and females, around 4%.² However, a study found nail psoriasis and psoriasis in the intertriginous region is slightly more common in males than females. In contrast, palmoplantar pustulosis is more common in women, and guttate, pustular, and localized plaque-type lesions may also be more common in women.

Despite a similar psoriasis prevalence, the skin disease affects each gender differently. Investigators sought to examine the differences in how males and females perceive PsA affecting their lives and what males and females think about their doctor discussions.¹

Eder and colleagues analyzed the results of an online questionnaire for patients with PsA, and participants came from Australia, Brazil, Canada, France, Spain, Taiwan, the United Kingdom, and the United States. They then compared the responses from males and females.

The survey discovered females are more likely than males to have tender joints, patches of flaking or red skin, tenderness or swelling between muscles and bones, even after taking medicine. Females were more likely to think their PsA affects their physical activity (81% vs 75%) and emotional well-being (73% vs 65%) in a major or medium negative way than males.

The survey also revealed the genders had different concerns regarding psoriasis. Females were more concerned about their psoriasis harming their life expectancy, and males worried their PsA would affect their ability to work.

“These results support that together with disease activity measures, life impacts of PsA should be carefully considered when implementing disease management strategies, where decision-making should be aligned with patient preferences,” investigators wrote.

Additionally, females were more satisfied than males when talking to their rheumatologist (60% vs 51%). Females were more likely than males to talk to their rheumatologist about treatment goals (83% vs 78%), their ability to do daily activities (82% vs 73%), and how well their medicine works along with their satisfaction with it (81% vs 72%).

Investigators also found a similar proportion of females and males reported they prevented disability and reduction of general swelling. However, fewer men reported these as goals. Another finding was that females were less likely to report switching medication.

The team stated the study was limited by respondents self-reporting data on PsA disease features, such as joint damage, tender joints, swollen joints, and enthesitis, with none of this information verified by patient medical records or their physicians. Another limitation investigators pointed out was more females in the sample had anxiety and depression, which could have impacted patient perception of pain-related outcomes and therapy responses. Lastly, investigators added the study was limited by the fact females may have been more likely to report their symptoms.

Ultimately, the data revealed males and females have different PsA experiences.

“It’s important for doctors to think about this when treating their patients,” investigators concluded.

References

1. ^{Eder L, Richette P, Coates LC, et al. Gender Differences in Perceptions of Psoriatic Arthritis Disease Impact, Management, and Physician Interactions: Results from a Global Patient Survey. Rheumatol Ther. Published online July 3, 2024. doi:10.1007/s40744-024-00678-x}
2. ^{Gonzalez-Cantero A, Constantin MM, Dattola A, Hillary T, Kleyn E, Magnolo N. Gender perspective in psoriasis: a scoping review and proposal of strategies for improved clinical practice by European dermatologists. Int J Womens Dermatol. 2023;9(4):e112. Published 2023 Nov 1. doi:10.1097/JW9.0000000000000112}