Excess weight tied to more severe psoriatic arthritis in women

In a tightly monitored treatment setting, female patients with psoriatic arthritis (PsA) have greater disease severity than their male peers, as shown in a study. Being overweight is a notable risk factor for higher disease activity in women, but not in men.

The analysis used routine practice data and included 855 PsA patients, who were all tightly monitored and treated. Outcomes such as Psoriatic Arthritis Disease Activity Score (PASDAS), skin/nail disease, Short-Form 12 physical and mental component summary scales (SF12-PCS/MCS), and inflammatory back pain (IBP) were assessed and compared between men and women.

Swollen and tender joints, C-reactive protein (CRP), enthesitis, and function, among others, were all unfavourable in women than in men (all p<0.001). Furthermore, women had much higher PASDAS scores (3.5 vs 2.7; p<0.001).

Multivariate logistic regression analyses showed that women were twice as likely as men to fall short of meeting the treatment target of PASDAS ≤3.2 (odds ratio [OR], 2.03; p<0.001). This was despite the similarity in the current medication they used.

Nail disease, IBP, number of disease-modifying antirheumatic drugs (DMARDs) used (past and current), and body mass index (BMI) factored in the failure to attain treatment target in the overall sample.

Finally, higher BMI was associated with failure to achieve PASDAS low disease activity in women (ORs, 2.41–3.43; p<0.001) but not men.