Smoking Status in patients with Psoriasis and Psoriatic Arthritis: An Irish Perspective
Conor Magee (1) F Farkas (1) N ikumi (1) A Szentpetery (1) P Gallagher (1) B Kirby (2) O FitzGerald (1)
1: Rheumatology, St Vincent's University Hospital 2: Dermatology, St Vincent's University Hospital
The BIOmarkers of COMorbidities (BIOCOM) in psoriasis study is a longitudinal study which aims to identify clinical, genetic or protein biomarker features associated with the development of co-morbidities, notably cardiovascular disease and psoriatic arthritis (PsA) in patients with psoriasis. Psoriasis usually precedes the development of PsA with an average interval of 10 years. Thus, psoriasis patients are an ideal group in which to study the early events in the evolution to PsA.
There is a well-established association between smoking and psoriasis, and between smoking and PsA in the general population. Paradoxically however, smoking has been shown to be negatively associated with the development of PsA in patients with established psoriasis. Herein we describe the prevalence of smoking in this BIOCOM cohort.
To date 190 patients with psoriasis have been recruited. Of those, 9 were excluded due to a diagnosis of psoriasis > 10 years previously. One was excluded due to a previous diagnosis of JIA. This left 180 patients with psoriasis who were brought in for an initial assessment. After the initial assessment 7 patients were diagnosed with PsA, meeting CASPAR criteria. This left 173 patients for inclusion in the analysis.
100 patients with established PsA were recruited and were included in the study.
Table 1 describes demographic and clinical characteristics of the study population at baseline assessment.
The proportion of smokers (current and past) was lower in the PsA group compared to the psoriasis group: 52.0 versus 63.6. Table 2 shows smoking characteristics of patients with PsA and psoriasis.
Analysis of patients recruited to date for the BIOCOM-Pso study shows a higher percentage of smokers (current and past) in the psoriasis group compared to the PsA group. The proportion of smokers (current and past) in the PsA group was comparable to the general Irish population.
These findings are consistent with previous studies that showed a negative association between smoking and the development of PsA in patients with psoriasis. However, prospective follow-up of patients with psoriasis, which is ongoing in this BIOCOM cohort, is required to further elucidate the role of smoking in the development of PsA.