Association of gender and systemic therapy treatment outcomes in psoriasis: a two-country, multi-centre, prospective, non-interventional registry study.

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Psoriasis is a stigmatizing disease that often affects female patients more negatively than male patients. Very little systematic data on the treatment responses related to gender exists.This two-country, multi-centre, prospective, non-interventional registry study aimed to evaluate potential gender differences with respect to systemic anti-psoriatic treatment.Data of patients with moderate to severe psoriasis participating in the German (PsoBest) or Swiss (SDNTT) psoriasis registry were analysed. Treatment response was defined as reaching PASI75 or PASI ≤ 3 at months 3, 6 and 12 of treatment and was supplemented by patient reported outcomes, i.e. DLQI ≤ 1 and Delta DLQI ≥ 4.5,346 patients registered between 2007 and 2016 were included in the analyses (4,896 from PsoBest and 450 from SDNTT). The majority of patients received a non-biologic treatment: 67.3 % of male and 69.8 % of female patients. Overall, women showed slightly higher PASI response rates after 3, 6 and 12 months, respectively 54.8 vs. 47.2 %, p ≤ 0.001, 70.8 vs. 63.8 %, p ≤ 0.001, 72.3 vs. 66.1%, p ≤ 0.004. In line with this, we found significantly higher proportions of female patients achieving a DLQI reduction ≥ 4: 61.4 vs 54.8 % at month 3 (p ≤ 0.001), 69.6 vs. 62.4 % at month 6 (p ≤ 0.001) and 70.7 vs. 64.4 % at months 12 (p ≤ 0.002), respectively. Females on biologics showed a significantly superior treatment response in the PASI ≤ 3 at 3 (57.8 vs 48.5%) p ≤ 0.004 and 6 months (69.2 vs 60.9%) p ≤ 0.018. The non-biologics group had a significant better treatment response (PASI response, PASI 75 and PASI ≤ 3) in females over the whole treatment year. Differences found in single treatments only occurred at individual points in time and did not show a uniform trend or can be regarded as methodological artefacts.Our data provide evidence that women experience better treatment outcome as measured by PASI to systemic anti-psoriatic therapy than men. Several factors may contribute to this observation, including adherence to treatment, weight, or different lifestyle behavior.

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Authors: J-T Maul, M Augustin, C Sorbe, C Conrad, F Anzengruber, U Mrowietz, K Reich, L E French, M Radtke, P Häusermann, L V Maul, W-H Boehncke, D Thaçi, A A Navarini