Sex Differences in the Effects of a Biological Drug for Rheumatoid Arthritis on Depressive State



Takahiro Tokunaga , Yusuke Miwa*, 1, Airi Nishimi 1, Shinichiro Nishimi 1, Mayu Saito 1, Nao Oguro 1, Yoko Miura 1, Sho Ishii 1, Ryo Takahashi 1, Tsuyoshi Kasama 1, Kenji Sanada 2
1 Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
2 Department of Psychiatry, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan


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© Tokunaga et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan; Tel: +81-3-3784-8942; Fax: +81-3-3784-8946; E-mail: y.miwa@mbf.ocn.ne.jp


Abstract

Objective :

Sex-specific medicine has attracted attention in recent years, but no report on rheumatoid arthritis (RA) has examined sex differences in the effectiveness of biologics on activities of daily living (ADL), quality of life (QOL), or depressive state.

Methods :

The study subjects were 161 RA patients (female: 138; male: 23) attending regular doctor visits at our hospital. We compared the changes in disease activity, which was evaluated using the simplified disease activity index (SDAI), ADL (using the modified health assessment questionnaire; mHAQ), QOL (using short form-36; SF-36), and the Hamilton Depression Rating Scale (HAM-D) for RA patients between each sex over a six-month observation period while administering biologic treatment.

Results :

The female patients reported significant improvements in the following metrics: SDAI: from 22.1 ± 11.9 to 8.9 ± 7.8 (p < 0.001); mHAQ: from 0.46 ± 0.50 to 0.32 ± 0.45 (p < 0.001); and HAM-D: from 6.2 ± 4.8 to 3.8 ± 4.1 (p < 0.001). Moreover, all eight items of the SF-36 were significantly improved (p < 0.01). In contrast, the male patients improved on the SDAI (from 27.9 ± 11.7 to 12.7 ± 8.6 (p < 0.001)), but we did not observe significant improvements in the mHAQ or HAM-D scores or in any items on the SF-36.

Conclusion :

Both male and female patients with RA improved when using a biological drug. Sex differences in the improvement of depressive state were observed.

Keywords: Biologic treatment, depression, gender difference, rheumatoid arthritis.