Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis

PROMPT Study Group

Research output: Contribution to journalArticle

Abstract

Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalBritish Journal of Dermatology
Early online date18 Jun 2019
DOIs
Publication statusE-pub ahead of print - 18 Jun 2019

ASJC Scopus subject areas

  • Dermatology

Cite this

Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis. / PROMPT Study Group.

In: British Journal of Dermatology, 18.06.2019, p. 1-7.

Research output: Contribution to journalArticle

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title = "Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis",
abstract = "Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20{\%} of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42{\%} male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95{\%} confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.",
author = "{PROMPT Study Group} and A Green and G Shaddick and R Charlton and J Snowball and A Nightingale and C Smith and W Tillett and N McHugh",
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AU - PROMPT Study Group

AU - Green, A

AU - Shaddick, G

AU - Charlton, R

AU - Snowball, J

AU - Nightingale, A

AU - Smith, C

AU - Tillett, W

AU - McHugh, N

N1 - © 2019 British Association of Dermatologists.

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N2 - Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.

AB - Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.

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JO - British Journal of Dermatology

JF - British Journal of Dermatology

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