Associations of gender with sexual functioning, loneliness, depression, fatigue and physical function amongst patients suffering from rheumatoid arthritis with a particular focus on methotrexate usage

Bay, Laila T; Nielsen, Dorthe S; Flurey, Caroline; Giraldi, Annamaria; Möller, Sören; Graugaard, Christian; Ellingsen, Torkell

Abstract

There is a lack of knowledge regarding methotrexate (MTX) usage in patients with rheumatoid arthritis (RA) and its possible links with gender, disease characterization and sexual functioning, loneliness, fatigue and depression. We, therefore, investigated the associations of gender with physical function, fatigue, depression, loneliness and sexual functioning with a particular focus on MTX usage. A cross-sectional study design was used. Inclusion criteria were RA diagnosis, age above 18years and available data on MTX treatment 1year after diagnosis. Data consisted of responses from validated questionnaires regarding physical function, fatigue, depression, loneliness and sexual functioning combined with evaluations from medical records. Data were analysed with linear regression models comparing numerical outcome measures between male and female patients and between MTX users and MTX non-users. Amongst 286 patients with RA (69 men and 217 women), 67.8% were MTX users 1year after diagnosis. Comparing women and men, both overall and within subgroups of MTX usage, we found significantly more adverse outcomes for women than men in physical functioning at diagnosis and in sexual function, depression, fatigue and physical functioning at enrolment in the study. Gender differences were also present when comparing MTX users with MTX non-users divided by gender. There were only significant differences in the HAQ and loneliness scores when comparing MTX users with MTX non-users. Women with RA had more negative outcomes measured by the selected PROMs compared to men with RA, both overall and in subgroups of users and non-users of MTX. These findings call for sharpened attention to the importance of gender in the treatment and care of patients with RA, as well as in future clinical research. [Abstract copyright: © 2024. The Author(s).]

• Journal Article Type: Article
• Acceptance Date: Jan 31, 2024
• Online Publication Date: Mar 14, 2024
• Publication Date: May 31, 2024
• Deposit Date: Mar 18, 2024
• Publicly Available Date: Apr 12, 2024
• Journal: Rheumatology international
• Print ISSN: 0172-8172
• Electronic ISSN: 1437-160X
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 44
• Article Number: 919–931
• DOI: https://doi.org/10.1007/s00296-024-05555-y
• Keywords: Patient-reported outcome measures, Sex, Gender, cross-sectional analyses, Rheumatoid Arthritis, Methotrexate
• Public URL: https://uwe-repository.worktribe.com/output/11824202
• Additional Information: Received: 13 December 2023; Accepted: 31 January 2024; First Online: 14 March 2024; : ; : AG receives consulting fees/honorarium from Futura Medical, Freya, and Pfizer, and for writing a manuscript from Pfizer, serves as a lecturer at Astellas, Pfizer, and Lundbeck, stocks Novo Nordisk, and provides expert testimony at Eli Lilly. All other authors declared no conflict of interest.; : The study was conducted according to relevant guidelines and regulations, and it was approved and registered by the Danish Data Protection Agency (case number: 2008-58-003) [CitationRef removed] and reported to The Danish Patient Safety Authority to obtain permission to collect data from medical records (case number: 3–3013-1445/1/), March 2016. No approval from the ethics committee was necessary according to Danish regulations.