Gender-related differences in patients with psoriatic arthritis

Psoriatic arthritis (PsA) is an inflammatory arthritis that affects up to 30% of patients with psoriasis. Gender-related differences have been extensively investigated in spondyloarthritis, particularly in ankylosing spondylitis, which shares several genetic and clinical characteristics with PsA. PsA affects men and women equally. Sex may play a role in the underlying genetic mechanisms of PsA. The inheritance of psoriasis and PsA may be implicated by genomic imprinting, which is a differential expression of a gene depending on the sex of the transmitting parent. Gender-related differences are observed in the clinical expression of PsA. Males are more likely to develop axial involvement, while women tend to present with peripheral polyarticular disease. Men also develop more severe radiographic damage in their spine, as well as in their peripheral joints. Women tend to discontinue treatment with anti-TNF-α agents earlier than men owing to inferior response and more side effects. Women with PsA also tend t...