title: Sex Differences in the Effects of a Biological Drug for Rheumatoid Arthritis on Depressive State.
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.
  
  
  CONCLUSIONS
  Both male and female patients with RA improved when using a biological drug. Sex differences in the improvement of depressive state were observed.
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Takahiro
authors: T
authors: Tokunaga
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Yusuke
authors: Y
authors: Miwa
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Airi
authors: A
authors: Nishimi
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Shinichiro
authors: S
authors: Nishimi
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Mayu
authors: M
authors: Saito
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Nao
authors: N
authors: Oguro
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Yoko
authors: Y
authors: Miura
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Sho
authors: S
authors: Ishii
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Ryo
authors: R
authors: Takahashi
authors: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Tsuyoshi
authors: T
authors: Kasama
authors: Department of Psychiatry, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors: Kenji
authors: K
authors: Sanada
keywords: Biologic treatment; depression; gender difference; rheumatoid arthritis