A big congratulations are in order for members of the Psoriatic Arthritis Research Program for receiving highly competitive awards to fund two exciting projects on sex and gender in psoriatic arthritis. Founder and director of the program, Dr. Lihi Eder, MD, PhD, as well as Steven Dang, PhD Student, will be working on the following projects.
Left to right: Dr. Lihi Eder and Steven Dang
Project Title: EXploring SEx-related Mechanisms of Psoriatic arthritis response to advanced therapies (EXSEMP): Individual participant data meta-analysis of randomized controlled trials of advanced therapies
Lead: Dr. Lihi Eder
Grant: Arthritis Society Canada awarded Dr. Eder with a 3-year operating grant, valued at $412,000
About: How a patient’s sex affects response to biologic treatments in psoriatic arthritis
Biologics are effective but expensive treatments for inflammatory arthritis. Female patients with psoriatic arthritis (PsA) are less likely to respond well to biologic therapies than male patients. Dr. Lihi Eder and her team aim to understand why this happens by analyzing data from clinical trials on biologic therapies for PsA. Using statistical models, they will investigate whether certain types of biologic treatments are more effective and safer for female patients. They will also examine if factors such as differences in inflammation levels, body weight, drug levels, or pain reporting could explain why female patients respond less to these treatments. The findings from this study could help create sex-specific guidelines for prescribing biologic treatments for PsA, leading to more effective and personalized care.
Project Title: Sex differences in the cellular immune profiles of males and females with psoriatic arthritis
Lead: Steven Dang, supervised by Lihi Eder
Award: Dang is the recipient of the CIHR CGS-Doctoral research award, $40K per year for 3 years
About: Males and females are affected differently by psoriatic arthritis (PsA).
Despite the disease being equally prevalent in males and females, differences exist in the disease course, clinical presentation, and response to drug therapies1. PsA is a disease that can cause severe skin psoriasis and permanent joint damage. Males with PsA often experience worse skin psoriasis and have a higher risk of spine and joint damage. In contrast, females tend to have higher disease activity, report higher pain levels, and have reduced quality of life. The biological mechanisms behind the differences in males and females with PsA remain poorly understood.
Treatment outcomes also differ by sex. Studies have shown that males with PsA are 2-3 times more likely to respond positively to their treatments. On the other hand, females often stop their drug treatments earlier due to poor effectiveness and increased side effects. A meta-analysis of randomized controlled trials in PsA found that males were more likely to respond positively to treatments overall and by the type of drug taken, including tumor necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i), and IL-12/23i3. However, there were no differences in treatment outcomes for males and females on Janus kinase inhibitors (JAKi) and tyrosine kinase inhibitors (TYKi)3. There needs to be a clearer explanation for these differing treatment responses across the various drug classes. Understanding the biological mechanisms driving these differing responses is critical for effectively managing PsA.
Dang aims to measure differences and changes in the immune system cells in males and females with PsA before and after starting drug therapy to explain the varying treatment responses. He will determine if the treatments were successful using standardized criteria commonly used in PsA. By studying these sex-specific mechanisms of PsA, they may uncover targets for new, sex-specific treatments or guide the selection of existing therapies.