Demographic data, comorbidities, quality of life, and survival probability of biologic therapy associated with sex‐specific differences in psoriasis in the Czech Republic

Abstract

BIOREP is a Czech registry of patients with psoriasis undergoing biological treatment. The objective of the study was to compare differences in demographic data, previous therapy, comorbidities, severity of psoriasis, quality of life, drug survival rates, and reasons for discontinuation between men and women. We analyzed a cohort of patients from the registry treated between May 2005 and January 2020. The total study population of 2472 patients (4051 treatment series) included 913 females and 1559 males. Women were significantly older than men at the onset of the biological treatment (47.8 vs 45.4 years, P < .0012) and the mean durations of psoriasis and that from its diagnosis until initiation of biological therapy, were longer in women (29.6 vs 27.2 years and 23.2 vs 20.6 years, P < .0012). Women as compared with men were also more often diagnosed with psoriatic arthritis (43.5% vs 33.0%, P < .0012). The prevalence rate of comorbidities was equivalent for both sexes except for that of depression (11.4% females vs 3.7% males, P < .0012). Both the DLQI and PASI scores were significantly different at baseline (DLQI = 16.0 and PASI = 19.5 for men vs DLQI 17.6 = and PASI = 17.7 for women, P < .0012). The survival probability with biological therapy was significantly lower in women for both biologically naïve and non-naïve patients, and there was more evidence of adverse effects in women. Our research demonstrates significant differences relative to multiple factors associated with psoriasis between men and women.

Use of Biological Treatments in Elderly Patients with Skin Psoriasis in the Real World

“…Although we did not find any differences in the overall survival of the biological drugs between the two age groups, it is interesting to note that the variables predicting the discontinuation of biological drugs in people under 65 years of age were different from those pertaining in the 65+ year age group. Thus, globally (under 65 and 65+ years) and in other registries, it has been pointed out that female sex, obesity, the presence of arthritis, and their previous use are the reasons for deciding to discontinue treatment with several biological drugs [49][50][51][52]. With ustekinumab, we found that arthritis was the only factor that reduced the survival of the drug in both age groups, similar to what was concluded from the Badbir study [49].…”

Factors associated with worsened clinical symptoms of psoriasis and disease-related quality of life during the COVID-19 lockdown: A cross-sectional study

“…Contrary to our hypothesis, male, but not female, sex contributed to impaired psoriasis-related QoL. Results in the scientific literature on the role of sex differences in psoriasis-related QoL are somewhat contradictory, with some studies showing no sex differences ( 21 , 42 ), some reporting lower QoL for females in comparison to males ( 43 , 44 ), and some suggesting the opposite ( 45 ). However, in our study sample, we had more males than females (21.5 vs. 10.3%) who were not receiving treatment for psoriasis, and more males than females (13.8 vs. 4.3%) who were living alone during the COVID-19 pandemic.…”

Sex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn

“…In the study by Kojanova et al (64), females were significantly older than males at the onset of the treatment, with a longer mean duration of the disease and a longer waiting time between diagnosis and commencement of the pharmacological treatment. Moreover, the survival probability under biologics was significantly lower in females for both biologically naïve and non-naïve patients.…”

“…Recently, Kojanova et al (64) mined BIOREP, a Czech registry of psoriatic patients under biologics. Females had a higher odds of being diagnosed with psoriatic arthritis (43.5% versus 33.0%, with a p-value less than 0.0012).…”