WOMEN with psoriatic arthritis (PsA) experience longer delays in diagnosis, more intense symptoms, and distinct challenges with treatment compared to men, according to findings presented by Lihi Eder at ACR Convergence 2024. PsA, an inflammatory autoimmune disease affecting joints and tendons, impacts approximately 30% of people with psoriasis and varies significantly based on sex and gender.
“Women endure a longer period of musculoskeletal symptoms with few physical signs before diagnosis,” said Eder, a rheumatologist and associate professor at Women’s College Hospital and the University of Toronto, Canada. This diagnostic delay may be due to overlapping conditions such as osteoarthritis or fibromyalgia, more common in women, as well as hormonal shifts like menopause.
Symptom Intensity and Quality of Life
Women report higher levels of pain, fatigue, and physical dysfunction compared to men, who are more likely to experience joint damage. Eder attributed these differences to biological and sociocultural factors, noting that societal stressors, pain perception, and coping mechanisms may all play a role.
Challenges in Treatment
Sex-based differences extend to treatment efficacy. Women tend to respond less effectively to biologic therapies and discontinue use earlier due to side effects. “Differences in immune profiles, drug metabolism, and the development of anti-drug antibodies may explain this variation, but more research is needed,” Eder emphasized.
The ongoing SAGE-PSA study, conducted by the Group for Research and Assessment of Psoriasis and PsA (GRAPPA), aims to address these gaps in understanding.
Unconscious Bias in Medicine
Eder highlighted potential unconscious biases in the healthcare system, which may lead to delayed or differing diagnostic approaches for women. She urged greater awareness and tailored strategies to ensure equitable care for patients with PsA.
As the field advances, the hope is to uncover targeted interventions that improve outcomes for all patients while addressing the unique challenges faced by women with PsA.
Reference: ACR. Women with Psoriatic Arthritis Experience More Intense Symptoms and a Longer Time to Diagnosis than Men. November 14, 2024. Available at: https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/blt4c18ca35f78e9019/annual-meeting-press-release-eder-psoriatic-arthritis.pdf. Last accessed: November 26, 2024. [Press release].
