ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1436

The Association of Cigarette Smoking with Radiographic Progression in Psoriatic Arthritis

Fadi Kharouf1, Hernan Maldonado Ficco2, Shangyi Gao3, barry J Sheanne4, Daniel Pereira5, Richard Cook6, Vinod Chandran7 and Dafna Gladman8, 1University Health Network and University of Toronto, Toronto, ON, Canada, Toronto, ON, Canada, 2Hospital San Antonio de Padua, Cordoba, Argentina, 3Toronto Western Hospital, University of Toronto, Toronto, ON, Canada, 4St James' Hospital, Dublin, Ireland, 5University Health Network, Toronto, ON, Canada, 6University of Waterloo, Waterloo, Canada, 7University of Toronto, Toronto, ON, Canada, 8University of Toronto, Toronto Western Hospital, Toronto, ON, Canada

Meeting: ACR Convergence 2024

Keywords: , ,

Session Information

Date: Sunday, November 17, 2024

Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: The association between smoking and radiographic damage has been established in axial spondyloarthritis and rheumatoid arthritis, but not in psoriatic arthritis (PsA). We designed this study to investigate this relationship in PsA.

Methods: We included patients with PsA followed at our prospective observational cohort. Smoking status was evaluated from the baseline visit up until the first detection of progression of radiographic damage, defined as an increase of ≥1 point on the modified Steinbrocker score (mSS). We classified patients as non-smokers, past smokers, and current smokers. We used Cox regression analysis to determine the factors associated with the time to progression of peripheral joint damage; to account for potential collider bias, which could be introduced by uncontrolled confounding, we evaluated the following covariates at baseline only (and not longitudinally): swollen joint count (SJC), dactylitis, mSS, and abnormal erythrocyte sedimentation rate (ESR).

Results: Of 1736 patients included in the study, 952 (54.9%) were males, with a mean (standard deviation) age of 44.9 (13.3) years and PsA duration of 6.3 (8.1) years at baseline (Table 1). 906 (52.2%) were non-smokers, 211 (12.2%) were past smokers, and 311 (17.9%) were current smokers; 308 (17.7%) had missing smoking data. At baseline, 744 (52.1%) patients had erosions, with a median [interquartile range] mSS of 2.0 [0.0, 10.0]. In the multivariate Cox regression model, older age (HR 1.01, p< 0.001), shorter duration of psoriasis (HR 0.99, p=0.004), higher baseline SJC (HR 1.02, p=0.01) and mSS (HR 1.01, p< 0.001), as well as baseline dactylitis (HR 1.49, p< 0.001) and abnormal ESR (HR 1.32, p=0.004) were all associated with a shorter time to progression of joint damage (Table 2). Smoking (current and past; HR 0.74, p=0.01 and HR 0.78, p=0.046, respectively) and use of advanced therapy (biologic or targeted synthetic drugs) (HR 0.61, p=0.002) were associated with a longer time to progression of joint damage.

Conclusion: Cigarette smoking does not appear to be positively associated with the progression of peripheral joint damage in PsA. Further studies are required to confirm our findings.

Supporting image 1

Supporting image 2

Disclosures: F. Kharouf: None; H. Maldonado Ficco: None; S. Gao: None; b. Sheanne: None; D. Pereira: None; R. Cook: None; V. Chandran: AbbVie/Abbott, 1, 5, AstraZeneca, 12, Spousal employment, Bristol-Myers Squibb(BMS), 1, Eli Lilly, 1, Janssen, 1, Novartis, 1, UCB, 1; D. Gladman: AbbVie, 2, 5, Amgen, 2, 5, AstraZeneca, 2, BMS, 2, Celgene, 2, 5, Eli Lilly, 2, 5, Galapagos, 2, 5, Gilead, 2, 5, Janssen, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, UCB, 2, 5.

To cite this abstract in AMA style:

Kharouf F, Maldonado Ficco H, Gao S, Sheanne b, Pereira D, Cook R, Chandran V, Gladman D. The Association of Cigarette Smoking with Radiographic Progression in Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/the-association-of-cigarette-smoking-with-radiographic-progression-in-psoriatic-arthritis/. Accessed .

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