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Treating Psoriatic Arthritis

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How Psoriatic Arthritis Affects Men and Women Differently

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Female patient showing nurse hand in examination room
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Approximately 1 in 4 people with the skin condition psoriasis will also develop psoriatic arthritis. Like other forms of arthritis, psoriatic arthritis can cause pain and swelling in your joints, leading to difficulties with movement and daily functioning.

Interestingly, several studies have shown gender differences in the experience of psoriatic arthritis. Here’s what we know about how this disease can vary between men and women.   

Psoriatic arthritis tends to affect different parts of men’s versus women’s bodies.

Psoriatic arthritis is a chronic disease that may get worse over time. It can cycle between periods of more intense symptoms (flare-ups) and periods of remission or improvement.  

Women are more likely than men to develop psoriatic arthritis symptoms in their peripheral joints: areas such as elbows, wrists, fingers, and toes. These joints are often affected symmetrically, on both sides of the body. Women also more commonly experience polyarthritis, a term used to describe arthritis that affects at least five joints.

Men, however, are three times more likely than women to develop axial psoriatic arthritis, which affects joints of the spine. This can manifest as pain and stiffness in the shoulders, neck, back, and hips.

 

Women often experience greater impairment from psoriatic arthritis.

In addition to joint pain, psoriatic arthritis can cause pain where your tendons and ligaments attach to bones, such as the back of your heel. It can lead to uncomfortable eye inflammation and changes in your nails. Psoriatic arthritis is also associated with an increased risk for certain medical conditions, such as high blood pressure, diabetes, and heart disease.

A number of studies have looked at the impact of psoriatic arthritis on individuals’ quality of life. Compared to men, women have reported:

  • Increased fatigue
  • More pain
  • Greater work disability or limitations
  • More difficulties performing activities of daily living

Some psoriatic arthritis treatments may work better for men.

Psoriatic arthritis is often treated with medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to relieve pain and decrease inflammation in mild cases. Steroid injections can be given into an affected joint. Disease-modifying antirheumatic drugs (DMARDs), can help by suppressing your body’s immune system response and slowing the progression of psoriatic arthritis.

One particular type of DMARD called a tumor necrosis factor-alpha (TNF-alpha) inhibitor is frequently prescribed to treat psoriatic arthritis. It works by blocking a protein in your body that causes inflammation. Examples include adalimumab (Humira), infliximab (Remicade), and etanercept (Enbrel).

One study examined the gender differences in treating psoriatic arthritis with TNF-alpha inhibitors. It was reported that these drugs were more effective in males. Men showed a better response to treatment at three and six months after it was initiated. Women also had a greater likelihood of discontinuing treatment due to side effects or lack of improvement.

Learning about these differences can improve psoriatic arthritis treatment in the future.

Research continues to deepen our understanding of psoriatic arthritis. Recognizing how this disease impacts men and women differently can help your doctor:

  • Identify and diagnose psoriatic arthritis more efficiently
  • Understand the impact of psoriatic arthritis on quality of life
  • Select which treatments will be most effective

We still don’t know exactly why these differences occur. Future studies will likely focus on the biological differences between men and women, looking at things like genes and hormones, to provide more answers and help develop new therapies for psoriatic arthritis.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 29
View All Treating Psoriatic Arthritis Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. The Effect of Gender on Disease Activity and Clinical Characteristics in Patients with Axial Psoriatic Arthritis. Modern Rheumatology. https://www.tandfonline.com/doi/abs/10.1080/14397595.2020.1812870?scroll=top&needAccess=true&journalCode=imor20
  2. Psoriatic Arthritis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
  3. Gender differences in biologic treatment outcomes—a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers. Rheumatology. https://academic.oup.com/rheumatology/article/57/9/1651/5035371
  4. Determinants of Patient-Reported Psoriatic Arthritis Impact of Disease: An Analysis of the Association With Sex in 458 Patients From Fourteen Countries. Arthritis Care & Research. https://pubmed.ncbi.nlm.nih.gov/31609525/
  5. Psoriatic Arthritis. Medscape. https://emedicine.medscape.com/article/2196539-overview#a5
  6. Clinical Differences between Men and Women with Psoriatic Arthritis: Relevance of the Analysis of Genes and Polymorphisms in the Major Histocompatibility Complex Region and of the Age at Onset of Psoriasis. Clinical and Developmental Immunology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652135/
  7. Gender Differences in Psoriatic Arthritis With Fatigue, Pain, Function, and Work Disability. Journal of Psoriasis and Psoriatic Arthritis. https://journals.sagepub.com/doi/abs/10.1177/2475530319870776