Sex-specific outcomes in methotrexate therapy among patients with psoriatic arthritis and psoriasis.
5 affiliations
- 1Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
- 2Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
- 3Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
- 4Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
- 5Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands.
Abstract
Objectives
The purpose of this paper is to identify sex-specific patterns in methotrexate (MTX) therapy among patients with psoriatic arthritis (PsA) and psoriasis (PsO).Methods
Data from adult patients treated with MTX monotherapy included in the Dutch southwest Early Psoriatic Arthritis Registry (rheumatology) or Continuous Assessment of Psoriasis Treatment Use REgistry with Methotrexate (dermatology) registries were obtained to create 2 cohorts of patients with PsA or PsO, respectively. Drug survival was assessed using Kaplan-Meier and Cox regression analyses. Disease activity, dosing, adverse events, and subsequent treatments were evaluated.Results
A total of 525 (50.1% female) patients were included in the PsA cohort and 217 (41.1% female) patients in the PsO cohort. In the PsA cohort, female sex was associated with shorter drug survival (adjusted hazard ratio [HR] = 2.5; 95% CI, 1.6-4.1; P < .001), whereas in the PsO cohort, female sex was associated with longer drug survival (HR = 0.6; 95% CI, 0.4-0.9; P = .008). Disease activity at MTX discontinuation was higher in females than males in the PsA cohort (Psoriatic Arthritis Disease Activity Score: 3.9 [1.0] vs 3.1 [1.5], P = 0.037), whereas in the PsO cohort, disease activity was higher in males than females (Psoriasis Area and Severity Index: 4.8 [6.4] vs 3.5 [3.7], P = .032). MTX dosing was comparable between sexes, though average doses were higher in the PsA than in the PsO cohort (18.2 [7.5] vs 15.0 [3.3] mg/wk, P < .001).Conclusions
Drug survival and treatment response of MTX vary between PsA and PsO, with females in the PsA cohort while males in the PsO cohort having worse outcomes.
Related
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BibTeX
@article{barenbrug2026sexspecific,
title = {{Sex-specific outcomes in methotrexate therapy among patients with psoriatic arthritis and psoriasis.}},
author = {Liana Barenbrug and Gonul Hazal Koc and Marisol E Otero and Emmerik F A Leijten and Sander I van Leuven and Irene E van der Horst-Bruinsma and Juul M P A van den Reek and Elke M G J de Jong and Marc R Kok and Marijn Vis and Michelle L M Mulder},
journal = {EULAR rheumatology open},
year = {2026},
month = oct,
doi = {10.1016/j.ero.2026.100255},
url = {https://europepmc.org/article/MED/42898461},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sex-specific outcomes in methotrexate therapy among patients with psoriatic arthritis and psoriasis.
AU - Liana Barenbrug
AU - Gonul Hazal Koc
AU - Marisol E Otero
AU - Emmerik F A Leijten
AU - Sander I van Leuven
AU - Irene E van der Horst-Bruinsma
AU - Juul M P A van den Reek
AU - Elke M G J de Jong
AU - Marc R Kok
AU - Marijn Vis
AU - Michelle L M Mulder
PY - 2026
DA - 2026/10/10
JO - EULAR rheumatology open
DO - 10.1016/j.ero.2026.100255
UR - https://europepmc.org/article/MED/42898461
AB - Objectives The purpose of this paper is to identify sex-specific patterns in methotrexate (MTX) therapy among patients with psoriatic arthritis (PsA) and psoriasis (PsO).Methods Data from adult patients treated with MTX monotherapy included in the Dutch southwest Early Psoriatic Arthritis Registry (rheumatology) or Continuous Assessment of Psoriasis Treatment Use REgistry with Methotrexate (dermatology) registries were obtained to create 2 cohorts of patients with PsA or PsO, respectively. Drug survival was assessed using Kaplan-Meier and Cox regression analyses. Disease activity, dosing, adverse events, and subsequent treatments were evaluated.Results A total of 525 (50.1% female) patients were included in the PsA cohort and 217 (41.1% female) patients in the PsO cohort. In the PsA cohort, female sex was associated with shorter drug survival (adjusted hazard ratio [HR] = 2.5; 95% CI, 1.6-4.1; P < .001), whereas in the PsO cohort, female sex was associated with longer drug survival (HR = 0.6; 95% CI, 0.4-0.9; P = .008). Disease activity at MTX discontinuation was higher in females than males in the PsA cohort (Psoriatic Arthritis Disease Activity Score: 3.9 [1.0] vs 3.1 [1.5], P = 0.037), whereas in the PsO cohort, disease activity was higher in males than females (Psoriasis Area and Severity Index: 4.8 [6.4] vs 3.5 [3.7], P = .032). MTX dosing was comparable between sexes, though average doses were higher in the PsA than in the PsO cohort (18.2 [7.5] vs 15.0 [3.3] mg/wk, P < .001).Conclusions Drug survival and treatment response of MTX vary between PsA and PsO, with females in the PsA cohort while males in the PsO cohort having worse outcomes.
SN - 3050-7081
ER -