Sex Differences in Medication Discontinuation in Axial Spondyloarthritis

IF 4.1 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2026-06-29 Epub Date: 2026-02-04 DOI:10.1002/acr.70001

Rachael Stovall, Cinthia Blat, Eric Roberts, Jean W. Liew, Katherine Wysham, Namrata Singh, Janna Friedly, Lianne S. Gensler, Gabriela Schmajuk, Jinoos Yazdany

{"title":"Sex Differences in Medication Discontinuation in Axial Spondyloarthritis","authors":"Rachael Stovall, Cinthia Blat, Eric Roberts, Jean W. Liew, Katherine Wysham, Namrata Singh, Janna Friedly, Lianne S. Gensler, Gabriela Schmajuk, Jinoos Yazdany","doi":"10.1002/acr.70001","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>We examined sex differences in medication discontinuation among patients with axial spondyloarthritis (axSpA) initiating tumor necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i), or JAK inhibitors (JAKi).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Using data from the Rheumatology Informatics System for Effectiveness (RISE) Registry (2003–2025), we assessed medication discontinuation by sex among new users of TNFi, IL-17i, and JAKi. Cox regression models were used to evaluate associations between sex and treatment discontinuation, adjusting for sociodemographic and clinical factors. We also examined medication continuation by sex and age group (18–64 vs ≥65 years) using Kaplan-Meier curves and tested for interactions between sex and age, race, and area deprivation index (ADI).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 7,200 individuals, the mean ± SD age was 52.7 ± 14.7 years; 58.3% were female and 68.7% were non-Hispanic White. Among TNFi users (N = 6,256), women had a 24% higher risk of discontinuation compared to men (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 1.16–1.32). Among IL-17i users (n = 693), women had a 25% higher risk of discontinuation (HR: 1.25; 95% CI: 1.01–1.54). No significant sex differences were observed among JAKi users (N = 251). Among TNFi users, women under 65 years had the lowest probability of treatment continuation. There was no statistically significant interaction between sex and age, race or ADI.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In a large US registry, women with axSpA were more likely to discontinue TNFi and IL-17i than men. Larger studies with longer follow-up since treatment approval are needed to confirm the lack of sex differences in JAKi discontinuation as this group could be underpowered.</p>\n </section>\n </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"914-924"},"PeriodicalIF":4.1000,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70001","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthritis Care & Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/acr.70001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

We examined sex differences in medication discontinuation among patients with axial spondyloarthritis (axSpA) initiating tumor necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i), or JAK inhibitors (JAKi).

Methods

Using data from the Rheumatology Informatics System for Effectiveness (RISE) Registry (2003–2025), we assessed medication discontinuation by sex among new users of TNFi, IL-17i, and JAKi. Cox regression models were used to evaluate associations between sex and treatment discontinuation, adjusting for sociodemographic and clinical factors. We also examined medication continuation by sex and age group (18–64 vs ≥65 years) using Kaplan-Meier curves and tested for interactions between sex and age, race, and area deprivation index (ADI).

Results

Among 7,200 individuals, the mean ± SD age was 52.7 ± 14.7 years; 58.3% were female and 68.7% were non-Hispanic White. Among TNFi users (N = 6,256), women had a 24% higher risk of discontinuation compared to men (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 1.16–1.32). Among IL-17i users (n = 693), women had a 25% higher risk of discontinuation (HR: 1.25; 95% CI: 1.01–1.54). No significant sex differences were observed among JAKi users (N = 251). Among TNFi users, women under 65 years had the lowest probability of treatment continuation. There was no statistically significant interaction between sex and age, race or ADI.

Conclusions

In a large US registry, women with axSpA were more likely to discontinue TNFi and IL-17i than men. Larger studies with longer follow-up since treatment approval are needed to confirm the lack of sex differences in JAKi discontinuation as this group could be underpowered.

Abstract Image

查看原文本刊更多论文

轴性脊柱炎停药的性别差异。

目的：我们研究了轴性脊柱炎（axSpA）患者在启动肿瘤坏死因子抑制剂（TNFi）、白细胞介素-17抑制剂（IL-17i）或Janus激酶抑制剂（JAKi）时停药的性别差异。方法：使用风湿病有效性信息系统（RISE）注册表（2003-2025）的数据，我们按性别评估TNFi、IL-17i和JAKi新使用者的停药情况。Cox回归模型用于评估性别与停药之间的关系，并对社会人口统计学和临床因素进行调整。我们还使用Kaplan-Meier曲线检查了性别和年龄组（18-64岁vs bb0 - 65岁）的药物持续情况，并测试了性别与年龄、种族和区域剥夺指数（ADI）之间的相互作用。结果：7200例患者中，平均（SD）年龄为52.7（14.7）岁；58.3%为女性，68.7%为非西班牙裔白人。在TNFi使用者（N= 6256）中，女性停药的风险比男性高24% （HR: 1.24; 95% CI: 1.16-1.32）。在IL-17i使用者（N=693）中，女性停药的风险高出25% （HR: 1.25; 95% CI 1.01-1.54）。在JAKi使用者（N=251）中没有观察到显著的性别差异。在TNFi使用者中，65岁以下的女性继续治疗的可能性最低。性别、年龄、种族或ADI之间没有统计学上显著的相互作用。结论：在美国的一项大型登记中，患有axSpA的女性比男性更有可能停止使用TNFi和IL-17i。需要更大规模的研究和更长时间的随访，以确认在JAKi停药中缺乏性别差异，因为这一组的疗效可能不足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

期刊介绍： Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.