Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Smoking has been shown to be associated with an increased risk of psoriatic arthritis (PsA) in the general population, but there are controversies among patients with psoriasis. We hypothesize that smoking is a risk factor for axial PsA specifically, similar to axial spondyloarthritis, more than the other PsA phenotypes.
Methods: PsArt-ID (Psoriatic Arthritis- International Database)] is a multicenter, international database, investigating the disease characteristics in real life. From that registry, 1535 PsA patients with smoking data were included for this analysis. Smoking status was categorized as never, current smoker or ex-smoker. Axial PsA was based on the clinicians’ judgement, requiring clinical features but not mandating any imaging. In addition grading of sacroiliitis was done by a central reader, whenever available. The effect of smoking, as well as other potential predictor factors on axial PsA and radiographic sacroiliitis, was assessed using a logistic regression analysis.
Results: Axial PsA was more common across current smokers compared to ex and non-smokers (38.9% vs 27.2% vs 26.8%, respectively; p< 0.001). Multivariate analysis to predict axial PsA showed that younger age [Odds ratio (OR)=0.98, 95% Confidence Interval (CI)= 0.97-0.99, p=0.014], male gender (OR=1.49, 95% CI=1.17-1.89, p=0.001), current smoking status (OR=1.42, 95% CI=1.07-1.88, p=0.014) and presence of nail disease (OR=1.43, 95% CI=1.14-1.80, p=0.002) were significant predictors for axPsA whereas polyarticular (OR=0.71, 95% CI=0.56-0.89, p=0.003) and distal joint involvement (OR=0.56, 95% CI=0.40-0.80 p=0.001) were protective (Table 1). Current smoking status was also found a significant predictor for radiographic sacroiliitis (OR=13.6, 95% CI= 2.87-64.6, p=0.001) (Table 2).
Conclusion: Current smoking is a significant risk factor for both axial PsA and radiographic sacroiliitis in patients with PsA, and not the peripheral phenotypes.
To cite this abstract in AMA style:Solmaz D, Kalyoncu U, Tinazzi I, Bakirci S, Bayindir O, Dogru A, Dalkılıç E, Kimyon G, Ozisler C, Cetin G, Kilic L, Omma A, Can M, Yılmaz S, Erden A, Aydin S. Current Smoking Status Increases the Risk of Axial Psoriatic Arthritis: An Explanation to Smoking Paradox [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/current-smoking-status-increases-the-risk-of-axial-psoriatic-arthritis-an-explanation-to-smoking-paradox/. Accessed July 12, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/current-smoking-status-increases-the-risk-of-axial-psoriatic-arthritis-an-explanation-to-smoking-paradox/