Female Patients Are Less Satisfied with Biological Treatment for Psoriasis and Experience More Side Effects Than Male Patients. Results from the Prospective BioCAPTURE Registry

BACKGROUND: 

Female sex has been reported as a predictor for treatment discontinuation with biological therapies for psoriasis, although reasons remain unclear. It can be hypothesized that lower satisfaction with biological treatment in women might add to the lower drug survival rates. 

OBJECTIVES: 

To identify possible differences in satisfaction with biological treatment between female and male patients using the Treatment Satisfaction Questionnaire for Medication (TSQM). 

METHODS: 

Data of psoriasis patients treated with biologics were obtained from the prospective, multicentre, daily-practice BioCAPTURE registry. Longitudinal TSQM data were analyzed by linear mixed models. Relevant patient characteristics were incorporated as possible confounding factors. Post hoc analysis of adverse events was performed in order to investigate differences between sexes. 

RESULTS: 

We included 315 patients with 396 corresponding treatment episodes (137 adalimumab, 90 etanercept, 137 ustekinumab, 24 secukinumab, 8 infliximab). Almost forty percent of the patients were female. Females had significantly lower baseline PASI scores (p=0.01). Longitudinal analyses demonstrated lower TSQM scores for ‘side effects’ (p=0.05) and ‘global satisfaction’ (p=0.01) in female patients compared to male patients over one year of treatment. Females reported more relevant adverse events in the context of biologic treatment compared to males (rate ratio 1.79; p<0.001), with more fungal (rate ratio 2.20; p=0.001) and herpes simplex infections (rate ratio 3.25; p=0.005). 

CONCLUSIONS: 

This study provides a prospective, longitudinal analysis of treatment satisfaction with biologics in female and male patients with psoriasis. Women were slightly less satisfied with treatment regarding side effects and global satisfaction. Differences in treatment satisfaction and side effects might add to the fact that women discontinue biological treatments more often.