Men with rheumatoid arthritis initiating treatment with biologic or targeted synthetic DMARDs may be more likely to achieve remission than women, suggests research reported at The Lancet Summit: Sex and gender in rheumatology.

Bergstra SA et al. J Rheumatol 2018. doi: 10.3899/jrheum.171176

Men with systemic sclerosis-associated interstitial lung disease may experience worse outcomes than women, which could be explained by sex differences in biomarker profiles, suggests a post-hoc analysis of the SLS I and SLS II trials.

Solomon and team’s findings were consistent across subgroups by age, sex, glucocorticoid and statin use, CV risk factors, RA duration, and serologic status.

Maher and team also conducted a subgroup analysis, finding that “there are perhaps some important differences between the CTD subgroups, but nonetheless the drugs seem to be effective across all of them.”

In the LOP group, the assessed comorbidities indices tended to have a higher score, but these data were not confirmed when corrected by age and sex.

The age- and sex-adjusted incidence rate per 10,000 person–years was numerically higher in those with versus without fecal hemoglobin (10.11 vs 8.96), albeit without reaching statistical significance.

Furthermore, there were no significant differences in the cumulative incidence of ADRD between each of the three targeted DMARD groups and the abatacept group.

When the individual autoimmune diseases were analyzed separately, the researchers say there was a trend toward reduced risk favoring supplementation for “almost all diseases”, but there were no significant between-group differences, which they say could be due to “the small numbers of participants with individual diseases.”

He said that the risk differences “are quite trivial” for people who have never smoked, but “I would probably have greater caution” for somebody with a long history of smoking.

Furthermore, Cox regression analysis, adjusted for age and sex, revealed that the people with PsA had a significant 41% lower risk for serious infection than those with RA.

The between-group differences for any of the measures were not statistically significant before or after adjustment for age and sex, “potentially due to sample size,” according to Emily Purcell, from the University of Pennsylvania in Philadelphia, USA, and colleagues.

The team also observed differences in secukinumab efficacy by sex, with significantly higher ASAS40 response rates with secukinumab versus placebo among men (51.2 vs 30.8%) but not women (31.7 vs 25.3%). medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group Arthritis Res Ther 2021; 23 : 231

The authors comment that “in contrast to the relatively uniform results for the response rates, the pronounced intercountry differences in TNF [inhibitor] retention suggests that factors other than biological/pharmaceutical [efficacy] may have an influence on observed retention rates.”

Barbulescu reported that after adjustment for a range of baseline factors, including demographics, disease activity, other medications, and comorbidities, there were no significant differences in treatment response rates among patients taking JAK inhibitors (n=905) compared with those on tumor necrosis factor (TNF) inhibitors (n=3497), rituximab (n=692), abatacept (n=694), or interleukin (IL)-6 inhibitors (n=534).

She added: “[K]nowledge of the broad variety of malignancies that present with musculoskeletal symptoms, as well as insight into the clinical differences between, and specific aspects of, juvenile idiopathic arthritis categories is of great importance.”

These differences are outlined in the table.