Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study

Background Few systematic data on sex-related treatment responses exist for psoriasis. Objectives To evaluate sex differences with respect to systemic antipsoriatic treatment. Methods Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a >= 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI <= 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) <= 1 and delta DLQI >= 4]. Results In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67.3% male, 69.8% female). Women showed slightly higher PASI response rates after 3 (54.8% vs. 47.2%; P <= 0.001), 6 (70.8% vs. 63.8%; P <= 0.001) and 12 months (72.3% vs. 66.1%; P <= 0.004). A significantly higher proportion of women achieved a reduction in DLQI >= 4 [month 3: 61.4% vs 54.8% (P <= 0.001); month 6: 69.6% vs. 62.4% (P <= 0.001); month 12: 70.7% vs. 64.4% (P <= 0.002)]. Regarding PASI <= 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57.8% vs. 48.5%; P <= 0.004) and 6 months (69.2% vs. 60.9%; P <= 0.018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI <= 3) over 12 months compared with men. Conclusions We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.