AB0890-HPR THE IMPACT OF GENDER ON PHYSICAL FUNCTION, FATIGUE, LONELINESS, DEPRESSION, AND SEXUAL FUNCTIONING IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH A SPECIAL FOCUS ON METHOTREXATE USAGE. A CROSS-SECTIONAL SINGLE-CENTRE STUDY
Authors: L. T. Bay, D. S. Nielsen, C. Flurey, A. Giraldi, S. Möller, C. Graugaard, T. Ellingsen
Journal: Annals of the Rheumatic Diseases (2021)

Background: We lack knowledge of how gender, disease characterization, and measures of various Patient Reported Outcome Measures (PROMS) relate to Methotrexate (MTX) usage in patients with rheumatoid arthritis. Objectives: To investigate the impact of gender on physical function, fatigue, depression, loneliness, and sexual functioning with a special focus on MTX usage. Methods: A cross-sectional study design was used to collect data in a rheumatologic outpatient clinic. The following PROMs were applied: Changes in Sexual Functioning Questionnaire, UCLA Loneliness Scale, Beck´s Depression Inventory, Bristol Rheumatoid Arthritis Fatigue-Numeric Rating Scale, and the Health Assessment Questionnaire. Results: Among 286 patients diagnosed with rheumatoid arthritis (69 men and 217 women), 67.8 % were defined as MTX-users one year after diagnosis. Comparing women and men we found differences in PROMS, with significantly worse outcomes for women than men in physical functioning at diagnosis and in sexual functioning, depression, fatigue, physical functioning, and patient evaluation of disease burden at enrolment in the study. There were only significant differences in the HAQ and loneliness score when comparing MTX-users with MTX-non-users in general (Table 1). Conclusion: The results of this study show that women have more negative outcomes on the selected PROMs compared to men with RA. This difference between genders was also evident when comparing MTX-users with non-MTX-users, again with a poorer outcome on PROMs for women compared to men. This calls for attention in the clinical setting and further research in the used instruments and the importance of gender in the care and treatment of patients with RA. Table 1. Second column is adjusted for gender, patient age, years of education, and living alone, all other columns are not adjusted for gender. HAQ Health Assessment Questionnaire, VAS Visual Analog Scale, UCLA University of California Los Angeles, CSFQ Changes in Sexual Functioning Questionnaire, BDI Becks Depression Inventory, BRAF-NRS Bristol Rheumatoid Arthritis Fatigue Numeric Rating Scale Adjusted analyses Comparing Women and men (overall ) Comparing MTX-users and non-MTX-users (overall ) Comparing women and men (MTX-user ) Comparing women and men (non-MTX-users ) Comparing male MTX-users and male non-MTX-users Comparing female MTX-users and female non-MTX-users Coefficient (95% CI ) p-value Coefficient (95% CI ) p-value Coefficient (95% CI ) p-value Coefficient (95% CI ) p-value Coefficient (95% CI ) p-value Coefficient (95% CI ) p-value Physical functioning at diagnosis HAQ 0.42 (0.19; 0.66) &lt;0.001 -0.31 (-0.59; -0.04) 0.024 0.30 (0.04; 0.56) 0.025 1.09 (0.68; 1.51) &lt;0.001 0.25 (-0.14; 0.64) 0.205 -0.54 (-0.84; -0.24) &lt;0.001 Physical functioning at enrollment HAQ 0.38 (0.20- 0.55) &lt;0.001 -0.13 (-0.29- 0.03) 0.101 0.39 (0.19- 0.59) &lt;0.001 0.30 (-0.07- 0.66) 0.112 -0.21 (-0.57- 0.16) 0.274 -0.11 (-0.30- 0.07) 0.216 PROMs at enrollment Sexual dysfunction CSFQ -12.16 (-14.80 - -9.52) &lt;0.001 -1.17 (-3.76- 1.41) 0.374 -13.30 (-16.27- 10.33) &lt;0.001 -9.20 (-14.90- -3.49) 0.002 1.99 (-3.45- 7.43) 0.473 -2.11 (-5.17- 0.95) 0.177 Loneliness UCLA 1.60 (-1.35 - 4.54) 0.288 4.15 (1.46- 6.85) 0.003 2.52 (-0.93- 5.98) 0.153 0.37 (-4.64- 5.38) 0.885 2.47 (-2.68- 7.61) 0.347 4.62 (1.50- 7.73) 0.004 Depression BDI 2.77 (1.04 - 4.50) 0.002 1.79 (-0.01- 3.58) 0.051 3.18 (1.07- 5.28) 0.003 2.14 (-0.50- 4.78) 0.112 0.98 (-1.58- 3.53) 0.454 2.01 (-0.15- 4.18) 0.068 Fatigue BRAF-NRS Severity 0.97 (0.31 - 1.63) 0.004 0.40 (-0.20- 1.00) 0.187 1.05 (0.30- 1.81) 0.006 0.87 (-0.50- 2.25) 0.212 0.26 (-1.13- 1.66) 0.713 0.44 (-0.24- 1.12) 0.201 Effect 1.06 (0.39 - 1.72) 0.002 0.25 (-0.38- 0.88) 0.442 1.07 (0.28- 1.86) 0.008 1.10 (-0.24- 2.44) 0.108 0.27 (-1.08- 1.63) 0.694 0.24 (-0.49- 0.98) 0.521 Coping 0.60 (-0.09- 1.28) 0.087 0.33 (-0.33- 0.99) 0.329 0.93 (0.13- 1.72) 0.022 -0.25 (-1.78- 1.28) 0.749 -0.60 (-2.17- 0.98) 0.457 0.58 (-0.15- 1.31) 0.120 Disclosure of Interests: Laila Twisttmann Bay: None declared, Dorthe S. Nielsen: None declared, Caroline Flurey: None declared, Annamaria Giraldi Speakers bureau: Astellas, Paid instructor for: Payment for lectures, Astellas, Consultant of: Ovaco Bio,Palatin Technologies, Futura Medical, Sören Möller: None declared, Christian Graugaard: None declared, Torkell Ellingsen: None declared