SAT0437 GENDER DIFFERENCES IN PsA OUTCOME PARAMETERS AND THEIR CORRELATION WITH SKIN INVOLVEMENT: A CROSS-SECTIONAL ANALYSIS OF RABBIT-SpA PAtients
Authors: A. Regierer, A. Weiß, F. Behrens, M. Feuchtenberger, G. Schett, X. Baraliakos, A. Zink, A. Strangfeld
Journal: Annals of the Rheumatic Diseases (2020)

Background: PsA is a complex disease characterised by a heterogeneous pattern including different clinical symptoms of musculoskeletal (MSK) inflammation like arthritis, enthesitis, dactylitis and axial involvement as well as skin and nail involvement. There are differences in these disease patterns between female and male patients which need to be taken into account. Objectives: To assess the differences between female and male PsA patients in the extent of psoriatic skin (body surface area, BSA) and joint (tender joint count 68, TJC68; swollen joint count 66, SJC66;) disease, composite scores (disease activity in PsA, DAPSA; disease activity score 28, DAS28), and patient-reported outcomes (PROs) and to correlate the extent of skin disease with PROs. Methods: RABBIT-SpA is a prospective longitudinal cohort study including PsA patients enrolled at start of a new csDMARD, bDMARD or tsDMARD. Gender specific differences in outcome parameters are compared using Wilcoxon resp. t-test at baseline visit. Spearman correlation coefficient was calculated to analyse the relationship between BSA and outcome parameters. Results: 722 PsA patients were included in this analysis. Women were slightly older (52 vs 50 yrs), had longer disease duration (7 vs 5.8 yrs), more comorbidities and were more often obese. Men had a significantly higher skin involvement than women measured by BSA and physician skin assessment (physSk, table 1). Women had significantly higher joint involvement as measured by TJC68, DAPSA, DAS28, and patient muskuloskeletal assessment (patMSK). Impact of disease as measured by PSAID and patient global assessment (patGA) was more severe in women than in men and also physical function (HAQ) was lower in women than in men (table 1). Despite the higher skin involvement in men, the DLQI was equally high in women and men with more than 50% of patients in reduced quality of life state (table 1). Table 1. Parameter Female N=424 Male N=298 SJC66 3.4 (5) 2.7 (3.8) TJC68 7.9 (8.7) 5.7 (7) BSA (0-100) 6.6 (13) 10.8 (16.5) physGA (NRS 0-10) 5.3 (1.9) 5.2 (2) physSk (NRS 0-10) 3.1 (2.7) 3.7 (2.6) physMSK (NRS 0-10) 5.2 (2.1) 4.9 (2.3) DAPSA 24.2 (13.8) 20.1 (12.3) DAS28-CRP 3.7 (1.2) 3.4 (1.2) patGA (NRS 0-10) 5.5 (2.1) 4.9 (2) patSk (NRS 0-10) 3.9 (3.1) 3.9 (2.8) patMSK (NRS 0-10) 5.8 (2.2) 5 (2.5) DLQI (0-30) 6.1 (6.8) 5.3 (5.7) HAQ (0-3) 1.1 (0.6) 0.7 (0.6) PSAID (0-10) 4.8 (2.3) 3.9 (2.2) Results are presented as mean ± SD. BSA was not correlated with SJC66 or TJC68, DAPSA, DAS28, phys MSK, patGA and patMSK neither in men nor in women. BSA was however positive correlated with DLQI, patSk, and physSK and slightly with physGA in both genders. The PSAID is correlated to BSA in women only. Conclusion: Women and men show differences regarding many PsA criteria. Men have a more severe skin involvement, while women have higher burden of joint involvement. In addition in the patient reported parameters women show significantly higher values than men except for the skin specific parameters. Notably, although skin involvement is not correlated with most PsA activity parameters, around 50% of patients in specialised rheumatologic care are negatively affected in their quality of life by psoriatic skin disease. Therapeutic decisions need to take into account the complexity of the patients’ symptoms as well as gender differences. Acknowledgments: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Janssen-Cilag, Lilly, MSD, Mylan, Novartis, Pfizer, and UCB. Disclosure of Interests: Anne Regierer Speakers bureau: Novartis, Celgene, Janssen-Cilag, Anja Weiß: None declared, Frank Behrens Grant/research support from: Pfizer, Janssen, Chugai, Celgene, Lilly and Roche, Consultant of: Pfizer, AbbVie, Sanofi, Lilly, Novartis, Genzyme, Boehringer, Janssen, MSD, Celgene, Roche and Chugai, Martin Feuchtenberger Consultant of: Abbvie, BMS, Chugai, Sanofi, Speakers bureau: Abbvie, BMS, Celgene, Chugai, Jansen-Cilag, Lilly, Pfizer, Roche, Sanofi, UCB, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis