AB0788 GENDER DIFFERENCES IN PSORIATIC ARTHRITIS DISEASE CHARACTERISTICS: EVIDENCE FOR WORSE DISEASE IN WOMEN.
Authors: A. Grivas, I. Kapniari, K. Tzannis, D. Tseronis, M. Aggelakos, D. Kassara, K. Havatza, S. Flouda, D. Nikolopoulos, T. Karageorgas, E. Papadavid, D. Boumpas, P. Katsimpri
Journal: Annals of the Rheumatic Diseases (2020)

Background: Psoriatic arthritis (PsA) affects both sexes equally, however there seem to be significant differences in disease expression between the genders. Objectives: To investigate gender differences in disease manifestations, patient-reported outcomes and comorbidities among patients with PsA. Methods: This cross-sectional study of patients with PsA followed at an academic rheumatology outpatient clinic between 1/6/2017 and 1/12/2019. We compared clinical characteristics, patient-reported outcomes, disease activity and comorbidities in male and female patients with PsA. All patients were over 18 years of age and fulfilled the CASPAR criteria for PsA. Differences between gender in values of continuous variables were assessed by T-tests or Mann-Whitney tests. The association between categorical variables and gender was assessed by Pearson chi-square test or Fisher’s exact test. Results: 135 patients, 83 (62%) women and 52 (38%) men were included. Factors studied for gender differences are shown in Table 1. Women had significantly more tender (11 vs 3 p 0.001) and swollen (10 vs 3, p 0.013) joints, worse VAS (Visual Analogue Scale 0-10) pain (6 vs 5, p &lt;0.001), higher ESR (20 vs 11, p 0.001) and worse DAPSA(Disease Activity in Psoriatic Arthritis) (33 vs 18 p 0.006) and presented with more enthesitis (32.5% vs 13.5%, p 0.013). In contrast, men achieved Minimal Disease Activity (MDA) more frequently (26.9% vs 3.6% p&lt;0.001)and had significantly more comorbidities than women. Polyarthritic disease was more frequent in women (62% vs 31%), although at non-significant levels. Conclusion: Male patients with PsA have more comorbidities, while female patients have greater disease activity, worse patient reported outcomes and achieve MDA less frequently. References: [1]Determinants of Patient-Reported Psoriatic Arthritis Impact of Disease: An Analysis of the Association with Gender in 458 Patients from 14 Countries. [2]Orbai AM, Perin J, et al Arthritis Care Res (Hoboken). 2019 Oct 14. doi: 10.1002/acr.24090. Factor Women (n=83) Men (n=52) P value Median (25th-75 th percentile ) Age 55.1 (46.8-63) 56.6 (50-65.7) 0.419* BMI 27.9 (24.9-35) 30.1 (26.8-33.3) 0.181 # Pso duration/ PsA duration (years) 8.3 (3.9-24.5)/ 2.4 (0-5.7) 14.3 (4.7-22.7)/ 2.8 (0-6.4) 0.451 # /0.605 # Smoking (Packyears) 15 (5-30) 27.5 (0-46) 0.002 # TJC/SJC 11 (4-16)/ 10 (5-17) 3 (0-13)/ 3 (0-14) 0.001 # /0.013 # VASPain/ VASGA 6 (5-8)/ 5 (3-6) 5 (1-6)/ 4 (2-5) &lt;0.001*/ 0.121* CRP/ ESR 1.4 (0.4-3.2)/20(11-33) 1.1 (0.2-2.7)/ 11 (7-18) 0.398 # / 0.001 # BSA/PASI 0 (0-2)/0(0-2) 2 (0-6)/1(0-4.8) 0.139 # /0.258 # DAPSA 33 (24.1-45) 18 (9.3-45) 0.006 # n (% ) Enthesitis/ Dactylitis 27 (32.5)/ 20 (24.1) 7 (13.5)/ 10 (19.2) 0.013 ***/ 0.508*** Dyslipidemia 33 (40.2) 31 (59.6) 0.029*** Liver 3 (3.6) 7 (13.5) 0.046** Eyes 0 (0) 3 (5.8) 0.055** Uricemia 3 (3.6) 8 (15.4) 0.023** Depression or anxiety 16 (19.3) 11 (21.1) 0.817*** CAD 2 (2.4) 12 (23.1) &lt;0.001** DM 14 (16.9) 12 (23.1) 0.392 MDA 3 (3.6) 14 (26.9) &lt;0.001 *: T-test with unequal variances; # : Mann-Whitney test; **: Fisher’s exact test; ***: Pearson chi2 test; Pso: Psoriasis; PsA: Psoriatic arthritis; BMI: Body mass index; TJC: Tender joint count; SJC: Swollen joint count; VASPain: Visual analogue scale 0-10 for pain; VASGA: Visual analogue scale 0-10 for general assessement; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; BSA: Body surface area; PASI: Psoriasis area severity index; DAPSA: Disease activity in psoriatic arthritis; CAD: Coronary artery disease; DM: Diabetes mellitus; MDA: Minimal disease activity; Disclosure of Interests: ALEXANDROS GRIVAS: None declared, IRENE KAPNIARI: None declared, KIMON TZANNIS: None declared, Dimitrios Tseronis: None declared, Michail Aggelakos: None declared, Dimitra Kassara: None declared, KATERINA HAVATZA: None declared, Sofia Flouda: None declared, Dionysis Nikolopoulos: None declared, Theofanis Karageorgas: None declared, EVAGELIA PAPADAVID: None declared, DIMITRIOS BOUMPAS Grant/research support from: Unrestricted grant support from various pharmaceutical companies, PELAGIA KATSIMPRI: None declared