SEX DIFFERENCES IN EFFECTIVENESS OF FIRSTLINE TUMOR NECROSIS FACTOR INHIBITORS IN AXIAL SPONDYLOARTHRITIS; RESULTS FROM FIFTEEN COUNTRIES IN THE EUROSPA RESEARCH COLLABORATION NETWORK
Authors: P. Hellamand et al.
Data from randomized controlled trials indicated that female patients with ankylosing spondylitis respond less well to therapy with TNF inhibitors. This European registry study (EuroSpA) aimed to confirm this finding in a large real world patient population. Data from 6451 bDMARD naïve patients with axSpA initiating therapy with TNF-inhibitors were available. The effect of sex on the achievement of clinically important improvement (CII) according to ASDAS-CRP at 6 months was assessed. In the adjusted analysis the probability of females to reach CII was 15% lower than for males. A drug survival analysis including 26’608 axSpA patients revealed significantly lower retention rates in females as compared to males (69 vs 81% at 12 months). In addition, there are baseline differences in disease parameters. Females have lower CRP levels and higher patient reported outcome scores.
The results of this large real-world study with axSpA patients confirm that females respond less well to therapy with TNF inhibitors and differ in disease characteristics. Different disease presentation and response to therapy in females needs to be considered for optimal treatment of axSpA.