IMPACT OF GENDER IN JAK INHIBITORS PRESCRIPTION: ANALYSIS FROM A SINGLE CENTER COHORT

BackgroundGender differences in demographic and clinical features may have a direct impact in patient prognosis.ObjectivesWe aimed to investigate gender differences in disease manifestations, comorbidities and treatment among patients who had started treatment with Janus Kinase Inhibitors.MethodsA single center observational study was performed including patients who had initiated treatment with Tofacitinib, Baricitinib or Upadacitinib from September, 2017 to January, 2022. Demographic and clinical data was collected and subgroup analysis was performed.ResultsA total of 190 patients were included (84%) and their characteristics are exposed in Table 1. Discontinuation rate was 33% in men and 39% in women. In female patients, age of diagnosis was younger (p=0.04) and the disease evolution, longer (p<0.01). Rheumatoid Arthritis was more frequent in women and Psoriatic Arthritis in men. Smoking habit was more seen in females (p<0.01). High Blood Pressure and Diabetes Mellitus were more frequent in men but dyslipidemia was more seen in women with no statistical signification. Men were more likely to receive a JAKi in first indication (p<0.02). At the time of first dose of JAKi, DAS28 and SDAI were similar between both sexes but HAQ was higher in women. All the laboratory markers (CRP, ESR, RF and ACPA) were higher in women than in men.Table 1.POPULATION CHARACTERISTICS.Men group n=30 (16%)Women n=160 (84%)Age – years (ds)55.73 (14.66)53.57 (17.29)Age at diagnosis46.93 (15.64)39.9 (15.71)Disease evolution (years)10.73 (7.04)16.79 (11.88)Rheumatoid Arthritis21 (70%)139 (86.88%)Psoriatic Arthritits6 (20%)11 (6.88%)Juvenile Idiopathic Arthritis1 (3.33%)6 (3.75%)Other2 (6.67%)4 (2.5%)Baricitinib3 (10%)59 (36.88%)Tofacitinib22 (73.33%)81 (50.62%)Upadacitinib5 (16.67%)20 (12.5%)Race – number (%)Caucasian24 (88.89%)137 (86.16%)Latin3 (11.11%)21 (13.21%)Other0 (0%)1 (0.63%)Smokers – number (%)3 (17.65%)30 (27.03%)Mean glucocorticoid dosage – mg of prednisone or equivalent2.85 (3.37)4.53 (4.24)Comorbidities – number (%)10 (33.33%) 39 (24.38%) High blood pressure3 (10%)11 (6.88%)Diabetes Mellitus7 (23.33%)53 (33.12%)Dyslipidemia Fibromyalgia0 (0%)6 (5.45%) Prior bDMARD– number (%)Naïve patients17 (60.71%)55 (34.59%)1 bDMARD failure2 (7.14%)33 (20.62%)2 bDMARD failure3 (10.71%)21 (13.12%)3 or more bDMARD failure 6 (21.43%)45 (28.12%)DAS 28 – mean total score5.01 (1.13)5.02 (0.98)SDAI – mean total score22.31 (8.43)25.21 (9.24)HAQ – median total score1.38 (0.91, 1.5)1.62 (1.25, 1.88)CRP – mg/L5 (3.02, 11)7 (2, 18.9)ESR – mm/h16 (8, 32)29.5 (17, 49.5)Rheumatoid Factor16 (10, 166)37 (10, 169.5)ACPA138 (0.7, 340)204.5 (1.08, 340)ConclusionIn this analysis of 190 patients treated with JAKi we detect that the men uses JAKi more frequently in first indication than women. Women seems to have a longer disease evolution, more smoking habit and less cardiovascular risk than men.Disclosure of InterestsNone declared