Gender influence on ultrasound-assessed therapeutic response in rheumatoid arthritis: Insights from the GENder on UltraSound (GENUS) study.

OBJECTIVES

To assess whether the ultrasound-measured response to targeted therapy in rheumatoid arthritis (RA) differs between women and men.

METHODS

. The GENder on UltraSound (GENUS) was a multicentre, observational, prospective study. We included RA patients who initiated or switched targeted therapy, gender-balanced and women and men matched by age. Blinded clinical, laboratory, and ultrasound assessments were performed at baseline and three months. We obtained global scores for B-mode synovitis, Doppler synovitis, and the Global EULAR-OMERACT Synovitis Score. The primary outcome was the change in global ultrasound scores from baseline to three months after initiation or switching of targeted therapy.

RESULTS

. A total of 185 patients were included [92 (49.7%) women, 93 (50.3%) men]. At three months, 174 patients [90 (51.7%) women, 84 (48.3%) men] were evaluated, while 11 patients were lost to follow-up. Most clinical, laboratory, and ultrasound variables showed significant improvement from baseline to three months in both women and men (p < 0.01), with a large effect size (Wilcoxon signed-rank test r ≥ 0.5) for most variables in both genders. At three months, there were no significant differences in changes in clinical, laboratory, or ultrasound variables between genders (p > 0.05), and the effect size was small (Wilcoxon rank-sum test r < 0.2) for all variables. In multivariate regression analysis, no significant differences in ultrasound scores between women and men were observed after adjustment for potential confounders (p > 0.05).

CONCLUSIONS

. These results suggest that the short-term ultrasound-assessed response to targeted therapy in RA patients is similar in women and men.