Men and Women Respond Differently to Antipsoriatic Therapies

A woman at a dermatology consultation
A woman at a dermatology consultation
Sex differences and their effect on systemic psoriasis treatment is assessed.

Although women with psoriasis tend to have a higher disease burden than men, they may experience greater response to systemic antipsoriatic therapies than men with the skin disorder, according to study findings published in the British Journal of Dermatology.

In this study, a team of US and European researchers examined antipsoriatic treatment-related outcomes in 5346 patients with psoriasis who were registered in Germany’s PsoBest or Switzerland’s Swiss Dermatology Network of Targeted Therapies (SDNTT) registries from 2007 to 2016.

The investigators examined differences between the sexes in regard to treatment response, as defined by the achievement of a 75% or greater reduction in the Psoriasis Area and Severity Index (PASI 75) or PASI 3 or lower at 3, 6 and 12 months. Patient-reported outcomes, as assessed by the Dermatology Life Quality Index (DLQI) 1 or lower and delta DLQI 4 or higher, were also evaluated.

The average age of the overall cohort was 47.1 years, and the mean body mass index was 28.4. In addition, the mean PASI was 14.2, while the average affected body surface area (BSA) was 22.7%.

Approximately 70.3% of patients received nonbiologic agent therapies. A slightly higher percentage of women than men received nonbiologic agent treatments at time of registry entry (71.6% vs 69.4%, respectively).

In an analysis combining nonbiologic and biologic agent therapies, women had significantly higher PASI responses at 3 months (54.8% vs 47.2%; P ≤.001), 6 months (70.8% vs 63.8%; P ≤.001), and 12 months (72.3% vs 66.1%; P ≤.004).

More women also achieved a reduction in DLQI 4 or more by month 3 (61.4% vs 54.8%; P ≤.001), month 6 (69.6% vs 62.4%; P ≤.001), and month 12 (70.7% vs 64.4%; P ≤.002).

In the biological agent treatment group, a significantly greater percentage of women showed a treatment response (PASI ≤3) at months 3 (57.8% vs 48.5%; P ≤.004) and 6 (69.2% vs 60.9%; P ≤.018).

Although men in the study had less impairment in their health-related quality of life at baseline, they had lower absolute reductions at 3 months (5.4 vs 6.5; P ≤.001), 6 months (6.4 vs 7.8; P ≤.001), and 12 months (6.7 vs 8.3; P ≤.001).

Limitations of this study were the short follow-up duration as well as the small number of patients treated with newer therapies.

The investigators concluded the observed “sex differences in treatment outcome may also indicate a need for more personalized drug selection and therapeutic management to improve clinical outcomes” in psoriasis.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Maul JT, Augustin M, Sorbe C, et al. Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study. Published online April 10, 2021. Br J Dermatol. doi:10.1111/bjd.20387