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Wang Q, Wang J, Sun X, Liu L, Zhang M, Yu Y, Gao P, Hong S, Li X. Evidence-based dietary recommendations for patients with psoriasis: A systematic review. Clin Nutr 2025; 47:68-82. [PMID: 39987781 DOI: 10.1016/j.clnu.2025.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 02/04/2025] [Accepted: 02/04/2025] [Indexed: 02/25/2025]
Abstract
Psoriasis is a chronic recurrent inflammatory skin disease mediated by immune, genetic, and environmental factors. Numerous studies have demonstrated that the excessive consumption of certain pro-inflammatory foods, including alcohol, dairy products, high-sugar foods, and gluten, can exacerbate psoriasis. Thus, modifying one's dietary habits can alleviate psoriasis symptoms. However, high-quality evidence regarding the relationship between diet and psoriasis is currently lacking. This review provides insight into the dietary management of psoriasis by reviewing previous dietary therapies. An extensive search of the PubMed, Embase, and Cochrane databases for clinical studies of psoriasis and diet revealed that diets meeting Mediterranean, gluten-free, or calorie-restricted principles, dietary fiber, probiotic, prebiotic, and n-3 fatty acid contents may be associated with improved psoriasis outcomes. Additionally, patients with psoriasis should avoid consuming alcohol and high amounts of salt. Overall, based on findings from the current literature, this review aimed to guide dietary treatment options for patients with psoriasis.
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Affiliation(s)
- Qingyun Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiaoying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Liu Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Miao Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yuanting Yu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Pengbo Gao
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Seokgyeong Hong
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
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Pei W, Xu L, Zhong H, Wang Z, Yao R, Zhang L, Yang J, Li J, Feng Y, Lin Q, Li D, Zhou X, Pei D, Guo Y, Ma L, Luo Y, Zuo S, Wang L, Yan R, Su Y. Clinical features of inflammatory arthritis in daily practice-China's perspective. Clin Rheumatol 2025; 44:969-978. [PMID: 39853560 DOI: 10.1007/s10067-024-07262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 11/21/2024] [Accepted: 12/02/2024] [Indexed: 01/26/2025]
Abstract
OBJECTIVE This study aimed to analyze and compare the proportion of patients with different types of inflammatory arthritis and investigate the clinical characteristics, including symptoms and signs, medication choices, and disease activity, in the daily clinical practice of China. METHODS Patients with inflammatory arthritis were recruited from 16 Grade-A tertiary hospitals between August 2021 and April 2022. The medical profiles, encompassing sociodemographic characteristics, clinical and laboratory date, were collected. RESULTS This study included 2,693 patients with arthritis, with rheumatoid arthritis (RA) accounting for the highest proportion (50.50%). Significant differences were observed in terms of age, gender, body mass index (BMI), disease duration, smoking and family history among patients with different types of inflammatory arthritis. Physical activity and cold exposure were identified as the main predisposing factors for RA, psoriatic arthritis (PsA), osteoarthritis (OA), and ankylosing spondylitis (AS), while alcohol consumption was the most common inducing factor for gout. Hypertension and hyperlipidemia were the primary concomitant diseases in RA, OA, and AS, whereas hyperuricemia and hypertension were mainly associated with gout, psoriasis and diabetes were the most common comorbidities in PsA. Peripheral joints were predominantly affected in PsA, RA, OA, and gout, while axial joints were mainly affected in AS. Methotrexate and leflunomide were the main therapeutic drugs for RA, while biologics were commonly prescribed for PsA and AS. OA and gout patients mainly utilized nonsteroidal anti-inflammatory drugs (NSAIDs). CONCLUSION Patients with different types of inflammatory arthritis exhibited varying predisposing factors, joint inflammation, concomitant diseases, and medication choices, highlighting the importance of individualized approaches in the clinic. Key Points • 2,693 patients classified and diagnosed with inflammatory arthritis were recruited in this study from 16 Grade-A tertiary hospitals in China between August 2021 and April 2022. • This study analyzed and compared the proportion of patients with different types of arthritis in routine clinical practice in China. • Joint inflammation, comorbidities, and medication choices were assessed among patients with the most common types of arthritis in this study. • This study also provided some epidemiologically relevant information about inflammatory arthritis patients in China.
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MESH Headings
- Humans
- Male
- Female
- Middle Aged
- China/epidemiology
- Adult
- Arthritis, Rheumatoid/epidemiology
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/complications
- Arthritis, Psoriatic/epidemiology
- Arthritis, Psoriatic/drug therapy
- Arthritis, Psoriatic/diagnosis
- Arthritis, Psoriatic/complications
- Antirheumatic Agents/therapeutic use
- Aged
- Osteoarthritis/epidemiology
- Spondylitis, Ankylosing/drug therapy
- Spondylitis, Ankylosing/epidemiology
- Spondylitis, Ankylosing/complications
- Comorbidity
- Gout/epidemiology
- Gout/drug therapy
- Risk Factors
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Affiliation(s)
- Wenwen Pei
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Liling Xu
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Hua Zhong
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Ziye Wang
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Ranran Yao
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China
| | - Lei Zhang
- Department of Rheumatology and Immunology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Yang
- Department of Rheumatology and Immunology, Mianyang Central Hospital, Mianyang, China
| | - Jingyang Li
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, China
| | - Yuan Feng
- Department of Rheumatology and Immunology, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Qi Lin
- Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Dongsheng Li
- Department of Rheumatology, Ganzhou People's Hospital, Ganzhou, China
| | - Xinyao Zhou
- Division of Rheumatology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongxue Pei
- Department of Rheumatology, Jilin Hospital of Integrated Traditional Chinese and Western Medicine, Jilin, China
| | - Yanqiu Guo
- Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Li Ma
- Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China
| | - Yaping Luo
- Department of Rheumatology, Hebei Provincial Hospital of Traditional Chinese Medicine, Hebei, China
| | - Shufei Zuo
- Department of Rheumatology and Immunology, Xinxiang Central Hospital, Xinxiang, China
| | - Lin Wang
- Department of Rheumatology, Shaoyang Central Hospital, Shaoyang, China
| | - Rui Yan
- Department of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, China
| | - Yin Su
- Department of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China.
- Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China.
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Gendron E, Maguire S, Anderson M, Johnson SR, Inman RD, Haroon N. The effect of alcohol consumption on clinical outcomes and structural damage in patients with axial spondyloarthritis: A systematic literature review and meta-analysis. Joint Bone Spine 2025; 92:105794. [PMID: 39461411 DOI: 10.1016/j.jbspin.2024.105794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/27/2024] [Accepted: 09/25/2024] [Indexed: 10/29/2024]
Abstract
OBJECTIVE To systematically review the effects of alcohol consumption (AC) on disease-specific outcomes in axial spondyloarthritis (axSpA). METHODS A systematic review of observational studies on axSpA and AC was conducted. Multiple electronic databases were searched for keywords. Two investigators reviewed articles to assess for inclusion eligibility. The Joanna Briggs Institute Critical Appraisal checklist was employed to evaluate the risk of bias. Standardized mean differences (SMD) were used to synthesize the data and I2 was used to ascertain heterogeneity. Spinal pain, disease activity as measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS), and spinal radiographic progression based on the modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS) were examined as outcomes. RESULTS Search strategy identified 703 records; 13 articles were assessed for eligibility. Five studies (n=3858) were included. Compared to non-consumers, axSpA patients who consumed alcohol had lower BASDAI (SMD: -0.19, 95% CI: -0.37 to -0.02, I2=72.5%) and lower spinal pain (SMD: -0.17, 95% CI: -0.24 to -0.09, I2=0%). No significant difference was found for ASDAS (SMD: -0.19, 95% CI: -0.39 to 0.00, I2=36%). One cohort study on the spinal radiographic progression indicated greater radiographic progression among consumers (SMD: 0.35, 95% CI: 0.08 to 0.62). CONCLUSION AC appears to be associated with lower disease activity and spinal pain. However, these findings may reflect confounding by sex and smoking. Further longitudinal cohort studies with standardized measures for AC are warranted to assess the direction of alcohol's effect on structural damage progression.
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Affiliation(s)
- Evelyne Gendron
- Schroeder Arthritis Institute, Division of Rheumatology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON M5T2S8, Canada.
| | - Sinead Maguire
- Schroeder Arthritis Institute, Division of Rheumatology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON M5T2S8, Canada
| | - Melanie Anderson
- The Institute for Education Research, Library and Information Services, University Health Network, 222 St. Patrick Street, Toronto, ON M5T 1V4, Canada
| | - Sindhu R Johnson
- Schroeder Arthritis Institute, Division of Rheumatology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON M5T2S8, Canada; Division of Rheumatology, Department of Medicine, Mount Sinai Hospital, 60 Murray Street, 2nd Floor, Toronto, ON M5T 3L9, Canada; Clinical Epidemiology & Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
| | - Robert D Inman
- Schroeder Arthritis Institute, Division of Rheumatology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON M5T2S8, Canada; Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Avenue, Toronto, ON M5T 0S8, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Division of Rheumatology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON M5T2S8, Canada; Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Avenue, Toronto, ON M5T 0S8, Canada
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Kharouf F, Gladman DD. Advances in the management of psoriatic arthritis in adults. BMJ 2024; 387:e081860. [PMID: 39572047 DOI: 10.1136/bmj-2024-081860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2024]
Abstract
Psoriatic arthritis is an inflammatory arthritis that affects around 30% of patients with psoriasis. The disease spectrum includes peripheral arthritis, enthesitis, tenosynovitis, dactylitis, axial involvement, and skin and nail psoriasis in most patients. In addition to the cutaneous and musculoskeletal manifestations, several comorbidities can complicate the disease course, including cardiovascular disease, diabetes mellitus, metabolic syndrome, gout, anxiety, and depression. The management of patients with psoriatic arthritis begins with a careful assessment of the skin and joints and screening for comorbidities. This review describes the assessment tools and outcome measures used in the evaluation of patients with psoriatic arthritis. It summarizes the approach to therapy, including non-medicinal interventions such as education, lifestyle changes, physiotherapy, and occupational therapy. It discusses the evidence on pharmacologic treatments, including drugs used for symptomatic relief such as non-steroidal anti-inflammatory drugs, and those used to control the disease process; this last group comprises conventional synthetic disease modifying anti-rheumatic drugs (DMARDs), including methotrexate, leflunomide, and sulfasalazine, and biologic and targeted DMARDs, including anti-tumor necrosis factor (TNFα), anti-interleukin-17 (IL-17), anti-IL-12/23, and anti-IL-23 agents, as well as Janus kinase (JAK) inhibitors and phosphodiesterase 4 (PDE4) antagonists. Although these drugs are usually tailored to the clinical profile of the patient, biomarkers predictive of response to therapy are needed so that a more personalized approach can be followed.
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Affiliation(s)
- Fadi Kharouf
- University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
- Gladman-Krembil Psoriatic Disease Program, Toronto Western Hospital, Toronto, ON, Canada
| | - Dafna D Gladman
- University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
- Gladman-Krembil Psoriatic Disease Program, Toronto Western Hospital, Toronto, ON, Canada
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Fatica M, Çela E, Ferraioli M, Costa L, Conigliaro P, Bergamini A, Caso F, Chimenti MS. The Effects of Smoking, Alcohol, and Dietary Habits on the Progression and Management of Spondyloarthritis. J Pers Med 2024; 14:1114. [PMID: 39728027 DOI: 10.3390/jpm14121114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 11/13/2024] [Accepted: 11/14/2024] [Indexed: 12/28/2024] Open
Abstract
Spondyloarthritis (SpA) is a group of chronic inflammatory diseases affecting the spine and peripheral joints, causing pain, stiffness, and reduced mobility. This narrative review examines how lifestyle factors-specifically smoking, alcohol consumption, and unhealthy diet-contribute to the onset and progression of SpA. It highlights their impact on disease activity, comorbidities, radiographic damage, and treatment response. Therefore, healthcare providers are encouraged to support patients in making personalized lifestyle changes. These findings underscore the importance of a comprehensive approach to SpA management, integrating lifestyle modifications with conventional therapies for optimal disease control and improved outcomes.
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Affiliation(s)
- Mauro Fatica
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
| | - Eneida Çela
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
| | - Mario Ferraioli
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
| | - Luisa Costa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
| | - Alberto Bergamini
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
| | - Francesco Caso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rom Tor Vergata, 00133 Rome, Italy
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Cheemalavagu S, Jin Y, Husni ME. What Clinical Factors Affect Length of Transition to Psoriatic Arthritis in Patients With Psoriasis? ACR Open Rheumatol 2024; 6:553-560. [PMID: 38943257 PMCID: PMC11506553 DOI: 10.1002/acr2.11703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/22/2024] [Accepted: 05/20/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE We aimed to identify clinical and demographic features associated with the interval between psoriasis (PsO) and psoriatic arthritis (PsA). METHODS We identified patients with PsO and PsA diagnoses from our tertiary care psoriatic disease biorepository: a longitudinal, real-world database including clinical information and patient-reported outcomes. We used a multivariable a zero-inflated negative binomial model to evaluate several clinical and demographic features that may be associated with the time between PsO and PsA onset. RESULTS A total of 384 patients were included, of whom 52.2% were female. The mean age of PsO onset was 31.5 years. Advanced age at PsO onset was associated with a shorter interval between PsO and PsA. Based on our model, patients with PsO onset at age 42.6 years (upper end of the interquartile range [IQR]) had a 62% shorter expected interval compared with patients with PsO onset at age 18.9 years (lower end of IQR) (P < 0.001) and were more likely to have concurrent (onset within 6 months) diagnoses (odds ratio 4.56; 95% confidence interval 2.9-7.17). Patients with a body mass index (BMI) of 34 compared with a BMI of 26 had a 10% shorter interval between PsO and PsA, which trended toward statistical significance (P = 0.053). CONCLUSION Our study demonstrated that patients with a diagnosis of PsO at an older age have a shorter interval between PsO and PsA diagnoses and are more likely to have concurrent diagnoses compared with patients with an onset of PsO at a younger age. These results suggest that patients with a later onset of PsO may benefit from earlier PsA screening.
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Choi J, Han I, Min J, Yun J, Kim BS, Shin K, Kim K, Kim YH. Dosis‐Wirkungs‐Beziehung zwischen Alkoholkonsum und Psoriasis: Systematische Übersicht und Metaanalyse. J Dtsch Dermatol Ges 2024; 22:641-653. [PMID: 38730521 DOI: 10.1111/ddg.15380_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/11/2024] [Indexed: 05/13/2024]
Abstract
The association between psoriasis and alcohol consumption has been inconsistent across various studies. However, to the best of our knowledge, no dose-response meta-analysis has been performed to date. This study aims to investigate the association between alcohol consumption and psoriasis. The search was performed on July 27, 2021, using Embase and MEDLINE. The restricted cubic spline analysis was used to perform a dose-response analysis. We identified 3,904 studies, of which 48 studies with 1,702,847 individuals across 24 countries were included. Alcohol consumption was positively associated with psoriasis (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.27-1.70). In addition, a significantly increased OR for psoriasis was observed in males (OR, 1.84; 95% CI, 1.13-3.01) but not in females (OR, 1.22; 95% CI, 0.97-1.54). Based on eight studies, including three cohort and five case-control studies, the analysis revealed that with each additional gram of daily alcohol intake, the OR for psoriasis increased by 4%. We found a positive association between alcohol consumption and psoriasis. The association is more prominent in the group drinking more than 45 g of alcohol per day (3.2 alcoholic drink equivalent).
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Affiliation(s)
- Jeeyu Choi
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Ikjoon Han
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Joohong Min
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Jisang Yun
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Byung-Soo Kim
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Kihyuk Shin
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kihun Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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Choi J, Han I, Min J, Yun J, Kim BS, Shin K, Kim K, Kim YH. Dose-response analysis between alcohol consumption and psoriasis: A systematic review and meta-analysis. J Dtsch Dermatol Ges 2024; 22:641-652. [PMID: 38679782 DOI: 10.1111/ddg.15380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/11/2024] [Indexed: 05/01/2024]
Abstract
The association between psoriasis and alcohol consumption has been inconsistent across various studies. However, to the best of our knowledge, no dose-response meta-analysis has been performed to date. This study aims to investigate the association between alcohol consumption and psoriasis. The search was performed on July 27, 2021, using Embase and MEDLINE. The restricted cubic spline analysis was used to perform a dose-response analysis. We identified 3,904 studies, of which 48 studies with 1,702,847 individuals across 24 countries were included. Alcohol consumption was positively associated with psoriasis (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.27-1.70). In addition, a significantly increased OR for psoriasis was observed in males (OR, 1.84; 95% CI, 1.13-3.01) but not in females (OR, 1.22; 95% CI, 0.97-1.54). Based on eight studies, including three cohort and five case-control studies, the analysis revealed that with each additional gram of daily alcohol intake, the OR for psoriasis increased by 4%. We found a positive association between alcohol consumption and psoriasis. The association is more prominent in the group drinking more than 45 g of alcohol per day (3.2 alcoholic drink equivalent).
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Affiliation(s)
- Jeeyu Choi
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Ikjoon Han
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Joohong Min
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Jisang Yun
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Byung-Soo Kim
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Kihyuk Shin
- Department of Dermatology, College of Medicine, Pusan National University, Busan, Republic of Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kihun Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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Pelechas E, Kaltsonoudis E, Migkos MP, Koletsos N, Karagianni PG, Drosos AA, Voulgari PV. State of the Art Review on the Treatment of Psoriatic Disease. Mediterr J Rheumatol 2024; 35:66-72. [PMID: 38736956 PMCID: PMC11082764 DOI: 10.31138/mjr.040123.sot] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/13/2023] [Accepted: 12/04/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Psoriasis is an inflammatory skin disease that in some cases is accompanied by systemic manifestations. Given the varied clinical manifestations, the term psoriatic disease probably better reflects the clinical picture of these patients. Literature review In most cases, the skin lesions precede joint involvement as well as other potentially involved organs such as the intestine and the eye. Various immune-mediated cellular pathways such as that of TNFα, IL-23, IL-17 as well as other cytokines are involved in the pathophysiology of the psoriatic disease. Future insights A better understanding of the way they interfere with our immune system has led to remarkably better disease control and outcomes. This review aims to highlight the newest treatments for psoriatic disease, which are expected to significantly reduce unmet needs and treatment gaps.
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Affiliation(s)
- Eleftherios Pelechas
- Department of Rheumatology, Medical School, University of Ioannina, Ioannina, Greece
| | | | - Michalis P. Migkos
- Department of Rheumatology, Medical School, University of Ioannina, Ioannina, Greece
| | - Nikolaos Koletsos
- Department of Rheumatology, Medical School, University of Ioannina, Ioannina, Greece
| | | | - Alexandros A. Drosos
- Department of Rheumatology, Medical School, University of Ioannina, Ioannina, Greece
| | - Paraskevi V. Voulgari
- Department of Rheumatology, Medical School, University of Ioannina, Ioannina, Greece
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Ladehesa-Pineda ML, Ortega-Castro R, Puche-Larrubia MÁ, Granados REM, Dougados M, Collantes-Estévez E, López-Medina C. Smoking and alcohol consumption are associated with peripheral musculoskeletal involvement in patients with spondyloarthritis (including psoriatic arthritis). Results from the ASAS-PerSpA study. Semin Arthritis Rheum 2023; 58:152146. [PMID: 36516482 DOI: 10.1016/j.semarthrit.2022.152146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND An inverse association between alcohol consumption and disease activity and functional impairment has been observed in patients with spondyloarthritis (SpA). However, neither this association nor the influence of smoking has been investigated in peripheral manifestations of SpA. OBJECTIVES The objective of this study was to analyze the association between smoking and alcohol consumption and the presence of peripheral musculoskeletal manifestations (arthritis, enthesitis or dactylitis) and to determine the specific location of these manifestations. METHODS Patients from the worldwide cross-sectional ASAS-PerSpA study with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or psoriatic arthritis (PsA) according to their rheumatologist were included. Generalised linear mixed models used peripheral manifestation (or location) as a dependent variable, smoking status and alcohol consumption as fixed effects and country as a random effect. The interaction between smoking and alcohol was tested. Analyses were performed for each diagnosis (axSpA, pSpA and PsA). RESULTS A total of 4181 patients were included. In axSpA patients, smoking was associated with a lower prevalence of any peripheral manifestation, and current alcohol consumption was associated with a lower prevalence of both current arthritis and current enthesitis. In pSpA patients, current alcohol consumption was associated with a lower prevalence of current arthritis or enthesitis. In PsA patients, a significant association was found for arthritis with smoking and for enthesitis with alcohol consumption, and current alcohol consumption was associated with a lower prevalence of current arthritis or enthesitis. CONCLUSION Taking into account the country, smoking and alcohol are associated with a lower prevalence of peripheral manifestations.
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Affiliation(s)
- María Lourdes Ladehesa-Pineda
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain.
| | - Rafaela Ortega-Castro
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; University of Córdoba, Córdoba, Spain
| | - María Ángeles Puche-Larrubia
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Raquel Ena María Granados
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Maxime Dougados
- Université de Paris cite Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France
| | - Eduardo Collantes-Estévez
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; University of Córdoba, Córdoba, Spain
| | - Clementina López-Medina
- Rheumatology Department Reina Sofia University Hospital, Córdoba, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain; Université de Paris cite Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France
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11
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Abstract
Spondyloarthropathies, also known as spondyloarthritis, encompasses a spectrum of diseases classified by it's axial and peripheral musculoskeletal manifestations. Extra-articular features are common in SpA making these systemic rheumatologic diseases involve the skin, eye, gut, and other organ systems.Research has identified risk factors for the development of spondyloarthritis, particularly regarding genetic susceptibility and the strong association with HLA-B27. Multiple studies have elucidated clinical risk factors associated with SpA disease activity and severity. In this review, we aim to explore the environmental risk factors for spondyloarthritis.
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Affiliation(s)
- Yvette Farran
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA
| | - John Reveille
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA
| | - Mark Hwang
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA.
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12
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Roberts MJ, Leonard AN, Bishop NC, Moorthy A. Lifestyle modification and inflammation in people with axial spondyloarthropathy-A scoping review. Musculoskeletal Care 2022; 20:516-528. [PMID: 35179819 DOI: 10.1002/msc.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION People with axial spondyloarthritis (AS) have an inflammatory profile, increasing the risk of hypertension, type 2 diabetes, obesity, and dyslipidaemia. Consequently, AS is linked with co-morbidities such as cardiovascular disease (CVD). Physical inactivity, diet, smoking, alcohol consumption, and obesity influence inflammation, but knowledge of the interaction between these with inflammation, disease activity, and CVD risk in AS is dominated by cross-sectional research. METHODS A review of the literature was conducted between July 2020 and December 2021. The focus of the scoping review is to summarise longitudinal and randomised control trials in humans to investigate how tracking or modifying lifestyle influences inflammation and disease burden in patients with AS. KEY MESSAGES (1) Lifestyle modifications, especially increased physical activity (PA), exercise, and smoking cessation, are critical in managing AS. (2) Smoking is negatively associated with patient reported outcome measures with AS, plus pharmaceutical treatment adherence, but links with structural radiographic progression are inconclusive. (3) Paucity of data warrant structured studies measuring inflammatory cytokine responses to lifestyle modification in AS. CONCLUSION Increased PA, exercise, and smoking cessation should be supported at every given opportunity to improve health outcomes in patients with AS. The link between smoking and radiographic progression needs further investigation. Studies investigating the longitudinal effect of body weight, alcohol, and psychosocial factors on disease activity and physical function in patients with AS are needed. Given the link between inflammation and AS, future studies should also incorporate markers of chronic inflammation beyond the standard C-reactive protein and erythrocyte sedimentation rate measurements.
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Affiliation(s)
- Matthew J Roberts
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Amber N Leonard
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Nicolette C Bishop
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Arumugam Moorthy
- Department of Rheumatology, University Hospitals of NHS Trust, College of Life Sciences, University of Leicester, Leicester, UK
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13
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Alnaqbi KA, Hannawi S, Namas R, Alshehhi W, Badsha H, Al‐Saleh J. Consensus statements for evaluation and nonpharmacological Management of Psoriatic Arthritis in UAE. Int J Rheum Dis 2022; 25:725-732. [PMID: 35678066 PMCID: PMC9544782 DOI: 10.1111/1756-185x.14357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/23/2022] [Accepted: 05/17/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Psoriatic arthritis (PsA), a chronic inflammatory arthropathy, is often underdiagnosed in Middle Eastern countries, substantially impacting the treatment of affected individuals. This article aims to highlight current unmet clinical needs and provide consensus recommendations for region-specific evaluation methods and nonpharmacological therapies in the United Arab Emirates (UAE). METHOD An extensive literature review was conducted, focusing especially on global and regional guidelines for the evaluation and treatment of PsA. These form the basis of the consensus statements formulated. Additionally, an expert panel of key opinion leaders from the UAE reviewed these guidelines and available literature at an advisory board meeting to identify unmet needs, bridge clinical gaps in the UAE, and develop consensus statements for the evaluation and treatment of PsA. RESULT The consensus statements were developed based on overarching principles for the management of PsA, evaluation of patients with PsA, and nonpharmacological approaches for the management of PsA. The overarching principles included adopting a targeted, multidisciplinary approach, along with collaboration between rheumatologists and dermatologists in cases of clinically significant skin involvement. The panel also highlighted the value of composite disease severity measures for characterizing clinical manifestations of PsA. In terms of nonpharmacological management approaches, lifestyle modification (comprising dietary change, exercise, and cessation of smoking) and psychotherapy were recommended. CONCLUSION The consensus statements will aid healthcare professionals in clinical decision-making in the context of PsA.
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Affiliation(s)
- Khalid A. Alnaqbi
- Department of RheumatologyTawam HospitalAl AinUAE
- College of Medicine and Health SciencesUAE UniversityAl AinUAE
| | - Suad Hannawi
- Emirates Health Services (EHS)DubaiUAE
- Ministry of Health and PreventionDubaiUAE
| | - Rajaie Namas
- Division of Rheumatology, Department of Internal MedicineCleveland ClinicAbu DhabiUAE
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14
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Ro J, Kim SH, Kim HR, Lee SH, Min HK. Impact of lifestyle and comorbidities on seropositive rheumatoid arthritis risk from Korean health insurance data. Sci Rep 2022; 12:2201. [PMID: 35140294 PMCID: PMC8828827 DOI: 10.1038/s41598-022-06194-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 01/25/2022] [Indexed: 12/31/2022] Open
Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory arthritis in which primary prevention is key. However, the impact of lifestyle and comorbidities on RA development is unknown. Data from the Korean National Health Insurance Service (NHIS)-national sample cohort from 2002 to 2016 were used. At baseline, demographic characteristics, socioeconomic status, type of residential area, lifestyle behaviours (including exercise), and comorbidities (including the Charlson Comorbidity Index, CCI) were included. Cox regression analysis and Kaplan-Meier curves were used to evaluate the impact of lifestyle and comorbidities on seropositive RA occurrence. A total of 517,053 participants were included in the analysis for seropositive RA occurrence. Mean follow up duration was 71.5 and 142.3 person-month for seropositive RA occurrence group and non-occurrence group, respectively. Seropositive RA was diagnosed in 1,948 participants (0.37%) during follow-up. Cox regression analysis revealed that being aged between 40 and 79, a higher CCI, and hyperlipidemia resulted in elevated hazard ratios (HRs) for seropositive RA, whereas male gender, city residence, moderate alcohol consumption, high regular exercise and a BMI between 23 and 34.9 kg/m2 resulted in lower HRs. Using Korean NHIS data, the present study demonstrates that high-intensity regular physical exercise and moderate alcohol consumption are negatively associated with seropositive RA occurrence, which are modifiable lifestyle habits that might aid the primary prevention of seropositive RA.
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Affiliation(s)
- JunSoo Ro
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, Republic of Korea.
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15
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Chang YC, Hsu LA, Huang YH. Alcohol consumption, aldehyde dehydrogenase 2 gene rs671 polymorphism, and psoriasis in Taiwan. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Does the lifestyle of patients with psoriasis affect their illness? POSTEP HIG MED DOSW 2021. [DOI: 10.2478/ahem-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Psoriasis is one of the most common chronic, incurable inflammatory skin diseases, affecting 2–4% of the general population. Etiopathogenesis of this disease remains unclear. It is widely considered to be a multifactorial disorder caused by the interaction between inherited susceptibility alleles and environmental risk factors, such as lifestyle, diet, stimulants, foci of inflammation, and psychological factors. The widespread prevalence of psoriasis is a very significant health and socioeconomic problem. Treatment of psoriasis is based on relieving the acute symptoms of the disease. Despite the implementation of many therapeutic options, including biological treatment, effectiveness of these options is not always sufficient, or in some patients it is not satisfactory. In order to properly control the symptoms of the disease, the patient should be told that the therapeutic effect is achieved not only by pharmacotherapy but also by introducing appropriate healthy habits in everyday life. This article discusses the importance of patient-controlled factors that affect the severity of psoriasis. Theimportance of regular exercise, smoking avoidance, and reduced alcohol consumption is explained, as well as the importance for psoriasis treatment of psychotherapy and spa therapy. Understanding the essence of these factors in the treatment of psoriasis is important in achieving satisfactory therapeutic effects.
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17
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Mulder MLM, van Hal TW, Wenink MH, Koenen HJPM, van den Hoogen FHJ, de Jong EMGJ, van den Reek JMPA, Vriezekolk JE. Clinical, laboratory, and genetic markers for the development or presence of psoriatic arthritis in psoriasis patients: a systematic review. Arthritis Res Ther 2021; 23:168. [PMID: 34127053 PMCID: PMC8201808 DOI: 10.1186/s13075-021-02545-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
Twenty to thirty percent of psoriasis (Pso) patients will develop psoriatic arthritis (PsA). Detection of Pso patients that are (at risk for) developing PsA is essential to prevent structural damage. We conducted a systematic search of five bibliographic databases, up to May 2020. We searched for studies assessing markers (clinical, laboratory, genetic) associated with the development or presence of PsA in Pso patients. Study selection and quality assessment of the included studies was performed, followed by a qualitative best evidence synthesis to determine the level of evidence for a marker and its association with concomitant/developing PsA in Pso. Overall, 259 possible markers were identified in 119 studies that met the inclusion criteria. Laboratory markers related to inflammation and bone metabolism reached a strong level of evidence for the association (not prediction) of PsA in Pso. Only CXCL10 showed strong evidence for a positive predictive value for PsA in Pso. The importance of timely detecting PsA in a Pso population, and finding more (bio)markers contributing to early detection, remains high.
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Affiliation(s)
- Michelle L M Mulder
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, 6500 GM, Nijmegen, The Netherlands. .,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Tamara W van Hal
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, 6500 GM, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mark H Wenink
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, 6500 GM, Nijmegen, The Netherlands
| | - Hans J P M Koenen
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Elke M G J de Jong
- Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud University, Nijmegen, The Netherlands.,Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Juul M P A van den Reek
- Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johanna E Vriezekolk
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, 6500 GM, Nijmegen, The Netherlands
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18
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Karmacharya P, Chakradhar R, Ogdie A. The epidemiology of psoriatic arthritis: A literature review. Best Pract Res Clin Rheumatol 2021; 35:101692. [DOI: 10.1016/j.berh.2021.101692] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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19
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Wang Q, Luo Y, Chen M, Zheng X, Zhu W, Shen M, Kuang Y. Comparison of Behavioral Risk Factors and Cardiometabolic Comorbidities of Psoriatic Arthritis and Psoriasis: A Case-Control Study in Chinese Patients. Ther Clin Risk Manag 2021; 17:397-404. [PMID: 33976548 PMCID: PMC8104971 DOI: 10.2147/tcrm.s307102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Comparison of risk factors and comorbidities could help indicate the underlying mechanisms of diseases. This study aimed to compare behavioral factors and cardiometabolic comorbidities of PsA/psoriasis versus healthy controls to implicate the similarities and differences in potential pathogenic mechanisms for further research. Patients and Methods A case-control study in Chinese patients with PsA or psoriasis and healthy controls was conducted. Clinical information based on patient-reported and measured outcomes were collected. Multivariable logistic regression was used to investigate the associations, in terms of adjusted odds ratios (AORs). Results We randomly selected 171 patients with PsA, 342 with psoriasis, and 1026 healthy controls from our database, matching by age and sex. Dyslipidemia (AOR=4.62 for PsA and 2.97 for psoriasis) and alcohol drinking (AOR=3.20 for PsA and 3.62 for psoriasis) were significantly associated with both diseases. Overweight was inversely associated with both PsA (AOR=0.46, P=0.002) and psoriasis (AOR=0.56, P=0.001), while obesity was associated with PsA (AOR=2.02, P=0.025) but not psoriasis (AOR=0.87, P=0.621). Subgroup analysis by onset age of psoriatic lesions showed that former smoking was significantly associated with early-onset psoriasis (AOR=2.44, P=0.016) but not PsA (AOR=0.59, P=0.329). Laboratory test indicated that both PsA and psoriasis were associated with altered lipid profile. Conclusion PsA and psoriasis in Chinese patients share common behavioral and cardiometabolic risk factors including dyslipidemia and alcohol consumption. There is a U-shape association between BMI and PsA/psoriasis.
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Affiliation(s)
- Qiaolin Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
| | - Yan Luo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
| | - Menglin Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
| | - Xuanwei Zheng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, People's Republic of China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, People's Republic of China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People's Republic of China
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20
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Mahajan VK, Dhattarwal N, Chauhan PS, Mehta KS, Sharma R, Sharma A, Singh VK, Sharma J, Hooda S. The Association of Alcohol Use Disorder and Chronic Plaque Psoriasis: Results of a Pilot Study. Indian Dermatol Online J 2021; 12:128-133. [PMID: 33768034 PMCID: PMC7982022 DOI: 10.4103/idoj.idoj_226_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/01/2020] [Accepted: 06/28/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Association between alcohol consumption, alcohol use disorder, and clinical features of psoriasis patients has not been adequately studied in the Indian context. Objectives: To study the frequency of alcohol consumption, alcohol use disorder, and its association with age, gender, duration, and severity of psoriasis. Materials and Methods: One hundred and forty-six (M: F 6.3:1) patients completed the Alcohol Use Disorder Identification Test (AUDIT) questionnaire by World Health Organization (WHO). Excessive drinkers, occasional drinkers, and abstainers were defined. AUDIT provided a measure of alcohol consumption, its dependence, and its impact on daily life. The severity of psoriasis was graded as mild, moderate, and severe. Results: Seventy-four (50.7%) patients were aged ≤40 years and 51.4% of patients had the disease for <5 years. Psoriasis was mild in 48.6% and moderate to severe in 51.4% of patients, respectively. Only males (32.9%) were consuming alcohol in varying amounts; 19.9% were occasional drinkers (AUDIT score <8). Other 67.1% of patients completely abstained from alcohol consumption (AUDIT score 0). The remaining 13% were regular drinkers (AUDIT score >8) and had more severe psoriasis compared to patients having AUDIT score <8 (P < 0.05). A high level of alcohol use disorder and alcohol dependence was present in one patient each. Limitations: Few patients, particularly females may not have disclosed their alcohol consumption due to fear of stigmatization. Small number of patients, hospital-based cross-sectional study design, and no follow-up for clinical improvement after cessation of alcohol are other limitations. Conclusions: Alcohol consumption was associated with alcohol use disorder in 32.9% of patients (AUDIT score >8) and significantly severe psoriasis compared to 67.1% abstainers. Whether increased alcohol consumption is a consequence or a risk factor for chronicity of psoriasis needs large linear studies for confirmation.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Niharika Dhattarwal
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Reena Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Anuj Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Vijay K Singh
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Jyotshna Sharma
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
| | - Sheenam Hooda
- Department of Dermatology, Venereology, and Leprosy, Dr. Rajendra Prasad Govt. Medical College, (Tanda), Himachal Pradesh, India
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21
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Srivastava AK, Chand Yadav T, Khera HK, Mishra P, Raghuwanshi N, Pruthi V, Prasad R. Insights into interplay of immunopathophysiological events and molecular mechanistic cascades in psoriasis and its associated comorbidities. J Autoimmun 2021; 118:102614. [PMID: 33578119 DOI: 10.1016/j.jaut.2021.102614] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
Psoriasis is an inflammatory skin disease with complex pathogenesis and multiple etiological factors. Besides the essential role of autoreactive T cells and constellation of cytokines, the discovery of IL-23/Th17 axis as a central signaling pathway has unraveled the mechanism of accelerated inflammation in psoriasis. This has provided insights into psoriasis pathogenesis and revolutionized the development of effective biological therapies. Moreover, genome-wide association studies have identified several candidate genes and susceptibility loci associated with this disease. Although involvement of cellular innate and adaptive immune responses and dysregulation of immune cells have been implicated in psoriasis initiation and maintenance, there is still a lack of unifying mechanism for understanding the pathogenesis of this disease. Emerging evidence suggests that psoriasis is a high-mortality disease with additional burden of comorbidities, which adversely affects the treatment response and overall quality of life of patients. Furthermore, changing trends of psoriasis-associated comorbidities and shared patterns of genetic susceptibility, risk factors and pathophysiological mechanisms manifest psoriasis as a multifactorial systemic disease. This review highlights the recent progress in understanding the crucial role of different immune cells, proinflammatory cytokines and microRNAs in psoriasis pathogenesis. In addition, we comprehensively discuss the involvement of various complex signaling pathways and their interplay with immune cell markers to comprehend the underlying pathophysiological mechanism, which may lead to exploration of new therapeutic targets and development of novel treatment strategies to reduce the disastrous nature of psoriasis and associated comorbidities.
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Affiliation(s)
- Amit Kumar Srivastava
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Tara Chand Yadav
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Harvinder Kour Khera
- Tata Institute for Genetics and Society, Centre at InStem, Bangalore, 560065, Karnataka, India; Division of Biological Sciences, University of California, San Diego, La Jolla, CA, 92093, United States
| | - Purusottam Mishra
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Navdeep Raghuwanshi
- Vaccine Formulation & Research Center, Gennova (Emcure) Biopharmaceuticals Limited, Pune, 411057, Maharashtra, India
| | - Vikas Pruthi
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Ramasare Prasad
- Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
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22
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Laskowski M, Schiöler L, Gustafsson H, Wennberg AM, Åberg M, Torén K. Cardiorespiratory fitness in late adolescence and long-term risk of psoriasis and psoriatic arthritis among Swedish men. PLoS One 2021; 16:e0243348. [PMID: 33428629 PMCID: PMC7799831 DOI: 10.1371/journal.pone.0243348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/20/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic immune-mediated disease and psoriatic arthritis is a common coexisting condition. Cardiorespiratory fitness is the overall capacity to perform exertion exercise. Low levels of cardiorespiratory fitness are associated with negative health outcomes. Individuals with psoriasis have lower cardiorespiratory fitness compared with individuals without psoriasis. There are no previous studies exploring the association between cardiorespiratory fitness and new-onset psoriasis and psoriatic arthritis. METHODS With the objective to investigate whether low cardiorespiratory fitness in late adolescence increases the risk for onset of psoriasis and psoriatic arthritis, a cohort of Swedish men in compulsory military service between 1968 and 2005 was created using data from the Swedish Military Service Conscription Register. Cardiorespiratory fitness, estimated by maximum capacity cycle ergometer testing at conscription, was divided into three groups: high, medium, and low. Diagnoses were obtained using the Swedish National Patient Register and cohort members were followed from conscription until an event, new-onset psoriasis or psoriatic arthritis, occurred, or at the latest until 31 December 2016. Cox regression models adjusted for confounders at conscription were used to obtain hazard ratios with 95% confidence intervals for incident psoriasis and psoriatic arthritis. RESULTS During the follow-up period (median follow-up time 31 years, range 0-48 years), 20,679 cases of incident psoriasis and 6,133 cases of incident psoriatic arthritis were found among 1,228,562 men (mean age at baseline 18.3 years). There was a significant association between low cardiorespiratory fitness and incident psoriasis and psoriatic arthritis (hazard ratio 1.35 (95% confidence interval 1.26-1.44) and 1.44 (95% confidence interval 1.28-1.63), respectively). CONCLUSIONS These novel findings suggest that low cardiorespiratory fitness at an early age is associated with increased risk of incident psoriasis and psoriatic arthritis among men, and highlight the importance of assessing cardiorespiratory fitness early in life.
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Affiliation(s)
- Marta Laskowski
- Department of Dermatology and Venereology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- * E-mail:
| | - Linus Schiöler
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Gustafsson
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann-Marie Wennberg
- Department of Dermatology and Venereology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Kjell Torén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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23
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Founta O, Adamzik K, Tobin AM, Kirby B, Hevey D. Psychological Distress, Alexithymia and Alcohol Misuse in Patients with Psoriasis: A Cross-Sectional Study. J Clin Psychol Med Settings 2020; 26:200-219. [PMID: 30206746 DOI: 10.1007/s10880-018-9580-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study investigates (a) the prevalence of psychological distress, alexithymia and alcohol misuse in psoriasis patients; and (b) the relationship between psoriasis severity, alexithymia, alcohol and psychological distress in patients with psoriasis. A cross-sectional study was conducted. Outpatients (n = 184) with moderate to severe psoriasis completed a psychological screening battery. Measures included the Hospital Anxiety and Depression Scale, the Penn State Worry Questionnaire, the twenty-item Toronto Alexithymia Scale, the Dermatology Life Quality Index, the Psoriasis Area and Severity Index, the Self-Administered Psoriasis Area and Severity Index, and the Alcohol Use Disorders Identification Test. Demographic, clinical details and information on knowledge of psychosocial issues, alcohol and confidence on coping with distress and talking to others about psoriasis was also gathered. Alexithymia was associated with anxiety, depression and worry; subjective psoriasis severity was associated with worry. Alcohol misuse was related to anxiety and worry, but not to depression. Appropriate identification and treatment of alcohol difficulties and psychological distress of patients with psoriasis is needed.
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Affiliation(s)
- Ourania Founta
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
| | - Karoline Adamzik
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Anne-Marie Tobin
- Dermatology Department, The Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland
| | - Brian Kirby
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,Charles Department of Dermatology, St Vincent's University Hospital and School of Health Sciences, UCD, Dublin 4, Ireland
| | - David Hevey
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland
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24
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Soriano ER. Interventions on Modifiable Risk Factors for the Development of Psoriatic Arthritis. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2019. [DOI: 10.1007/s40674-019-00135-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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25
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Green A, Shaddick G, Charlton R, Snowball J, Nightingale A, Smith C, Tillett W, McHugh N. Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis. Br J Dermatol 2019; 182:714-720. [DOI: 10.1111/bjd.18227] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2019] [Indexed: 01/09/2023]
Affiliation(s)
- A. Green
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
- Department of Mathematical Sciences University of Bath Claverton Down Bath BA2 7AY U.K
| | - G. Shaddick
- Department of Mathematics University of Exeter Exeter U.K
| | - R. Charlton
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
| | - J. Snowball
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
| | - A. Nightingale
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
| | - C. Smith
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - W. Tillett
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
- Royal National Hospital for Rheumatic Diseases Upper Borough Walls Bath U.K
| | - N. McHugh
- Department of Pharmacy and Pharmacology University of Bath Claverton Down Bath BA2 7AY U.K
- Royal National Hospital for Rheumatic Diseases Upper Borough Walls Bath U.K
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26
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Alcohol consumption as a predictor of the progression of spinal structural damage in axial spondyloarthritis: data from the Catholic Axial Spondyloarthritis COhort (CASCO). Arthritis Res Ther 2019; 21:187. [PMID: 31412929 PMCID: PMC6692958 DOI: 10.1186/s13075-019-1970-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of the present study was to demonstrate whether alcohol consumption could predict spinal structural damage in axial spondyloarthritis (axSpA) in a prospective cohort study. METHODS AxSpA patients were enrolled from a single tertiary hospital in a prospective cohort. Baseline data were collected, and 2-year follow-up radiographic data were collected. We analyzed the progression of spinal structural damage in 278 axSpA patients and grouped them into alcohol drinkers and non-drinkers. Baseline and follow-up characteristics were compared between the two groups. Univariable and multivariable logistic regression analyses were performed to reveal predictors of spinal structural damage. RESULTS Changes in modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and syndesmophyte count over the 2-year period were more prominent in the alcohol drinker group than in the non-drinker group (2.7 ± 3.6 vs 1.5 ± 2.8, P = 0.007, 0.9 ± 1.3 vs 0.4 ± 1.2, P = 0.003). The alcohol drinker group showed more frequent significant mSASSS changes (≥ 2 units for 2 years follow-up) and new syndesmophyte/progression of pre-existing syndesmophytes than the non-drinker group (60.7% vs 29.2%, P < 0.001, 51.5% vs 26.4%, P < 0.001, respectively). On univariable and multivariable regression analyses, drinking alcohol showed a significant relationship with the progression of spinal structural damage for both mSASSS and syndesmophyte progression. CONCLUSION The present study showed the association between alcohol consumption and spinal structural progression in axSpA patients for the first time.
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27
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Preventing psoriatic arthritis: focusing on patients with psoriasis at increased risk of transition. Nat Rev Rheumatol 2019; 15:153-166. [DOI: 10.1038/s41584-019-0175-0] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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28
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Solmaz D, Eder L, Aydin SZ. Update on the epidemiology, risk factors, and disease outcomes of psoriatic arthritis. Best Pract Res Clin Rheumatol 2018; 32:295-311. [PMID: 30527433 DOI: 10.1016/j.berh.2018.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/21/2018] [Accepted: 09/09/2018] [Indexed: 02/08/2023]
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects different structures of the musculoskeletal system in addition to the skin and the nail. The complexity of the disease had been a barrier to understand the pathogenesis and define valid outcome tools; however, our understanding about the disease has considerably increased with time mainly because of the advances in imaging, new discoveries in genetics and underlying inflammatory pathways, and better understanding of the epidemiology of the disease and environmental risk factors. The purpose of this review is to summarize developments and changes in epidemiology, risk factors for developing PsA, and outcome measures with a focus on data obtained in the last 10 years.
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Affiliation(s)
- Dilek Solmaz
- Division of Rheumatology, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada; Izmir Katip Celebi University, Izmir, Turkey.
| | - Lihi Eder
- Women's College Research Institute, Women's College Hospital, The Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Sibel Zehra Aydin
- Division of Rheumatology, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada; The Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada.
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29
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Alcohol and disease activity in axial spondyloarthritis: a cross-sectional study. Rheumatol Int 2018; 38:375-381. [PMID: 29322342 PMCID: PMC5847073 DOI: 10.1007/s00296-018-3927-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/02/2018] [Indexed: 12/19/2022]
Abstract
The objective of this study was to explore associations between alcohol consumption and disease activity in axial spondyloarthritis (axSpA). We conducted a cross-sectional study of axSpA participants meeting the ASAS criteria. Associations between self-reported current alcohol use and disease activity (BASDAI, spinal pain, ASDAS), functional impairment (BASFI), and quality of life were explored using multivariable linear models, adjusting for age, gender, symptom duration, use of TNF inhibition therapy, smoking, deprivation, and anxiety and depression (A&D). Within alcohol drinkers, effect of increased alcohol intake (defined as > 14 units/week) was explored with moderate drinking (≤ 14 units/week) as reference. The study cohort comprised 229 axSpA patients and 76% were male with mean age 46.5 years (SD ± 13.8). Alcohol drinking was reported by 64%, with a median of 6 units per week among drinkers. Compared with non-drinkers, drinkers had lower BASDAI (β = - 0.83; 95% CI - 1.49, - 0.17), ASDAS (β = - 0.36; 95% CI - 0.66, - 0.05) and BASFI (β = - 1.40; 95% CI - 2.12, - 0.68). These associations were in contrast to, and independent of, the detrimental effects of smoking, depression, and deprivation. Subgroup analysis in alcohol drinkers did not reveal significant associations between disease severity and increased alcohol intake. Stratified analyses by smoking revealed that in never-smokers without depression, alcohol was associated with greater reduction in disease activity: BASDAI (β = - 1.69; 95% CI - 2.93, - 0.45), ASDAS (β = - 0.60; 95% CI - 1.18, - 0.02). Favourable axSpA disease activity and function were observed in association with alcohol consumption in this cross-sectional study. Longitudinal study is required to explore whether this relationship is due to biological effects of alcohol on disease process or disease-associated behaviour modification.
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30
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Gisondi P. High prevalence of alcohol use disorders in patients with inflammatory skin diseases applies to both psoriasis and eczema. Br J Dermatol 2017; 177:606-607. [DOI: 10.1111/bjd.15674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona 37126 Italy
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31
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Torre-Alonso JC, Carmona L, Moreno M, Galíndez E, Babío J, Zarco P, Linares L, Collantes-Estevez E, Barrial MF, Hermosa JC, Coto P, Suárez C, Almodóvar R, Luelmo J, Castañeda S, Gratacós J. Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain. Rheumatol Int 2017; 37:1239-1248. [DOI: 10.1007/s00296-017-3702-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/14/2017] [Indexed: 02/08/2023]
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32
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Lewinson RT, Vallerand IA, Lowerison MW, Parsons LM, Frolkis AD, Kaplan GG, Bulloch AG, Swain MG, Patten SB, Barnabe C. Depression Is Associated with an Increased Risk of Psoriatic Arthritis among Patients with Psoriasis: A Population-Based Study. J Invest Dermatol 2017; 137:828-835. [DOI: 10.1016/j.jid.2016.11.032] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/23/2016] [Accepted: 11/28/2016] [Indexed: 11/29/2022]
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33
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Li WQ, Cho E, Weinstock MA, Mashfiq H, Qureshi AA. Epidemiological Assessments of Skin Outcomes in the Nurses' Health Studies. Am J Public Health 2016; 106:1677-83. [PMID: 27459457 DOI: 10.2105/ajph.2016.303315] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To review the contribution of the Nurses' Health Studies (NHSs) to identifying epidemiological factors associated with multiple skin diseases, including skin cancer, psoriasis, and other inflammatory and autoimmune skin diseases. METHODS We carried out a narrative review of NHS articles published between 1976 and 2016. RESULTS The NHSs have identified environmental and lifestyle factors related to psoriasis, supporting obesity and smoking as psoriasis risk factors; associations between psoriasis and diabetes, myocardial infarction, and Crohn's disease, supporting psoriasis as a systemic disorder; and associations of pigmentary traits, ultraviolet radiation, and lifestyle factors such as citrus consumption with risk of skin cancer. Genetic studies have identified novel genetic loci for skin pigmentation (e.g., IRF4, SLC24A4, NID1, and EDNRB) and skin cancer (e.g., TET2 and HERC2-OCA2). Work continues on highly prevalent but less studied skin conditions such as rosacea, acne, and atopic dermatitis. The NHS results have influenced public health policies on indoor tanning devices. CONCLUSIONS The NHSs have provided invaluable resources on skin disease population science and contributed to the etiological understanding of multiple skin disorders.
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Affiliation(s)
- Wen-Qing Li
- The authors are with the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Eunyoung Cho
- The authors are with the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Martin A Weinstock
- The authors are with the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Hasan Mashfiq
- The authors are with the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Abrar A Qureshi
- The authors are with the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
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Clinical Risk Factors for the Development of Psoriatic Arthritis Among Patients with Psoriasis: A Review of Available Evidence. Curr Rheumatol Rep 2016; 17:64. [PMID: 26290111 DOI: 10.1007/s11926-015-0540-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Psoriatic arthritis (PsA), a chronic inflammatory arthritis, affects about 10% of patients with psoriasis with higher prevalence seen in patients with more extensive skin disease. Early identification of PsA may result in improved outcomes. While it remains unclear which patients with psoriasis will develop PsA, several studies have identified potential risk factors for PsA among patients with psoriasis. This review examines the basic epidemiologic principles of identifying risk factors and reviews the evidence to date about risk factors for PsA among patients with psoriasis.
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35
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Mahajan VK. Psoriasis treatment: Unconventional and non-standard modalities in the era of biologics. World J Dermatol 2016; 5:17-51. [DOI: 10.5314/wjd.v5.i1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/25/2015] [Accepted: 12/18/2015] [Indexed: 02/06/2023] Open
Abstract
Psoriasis is a potentially debilitating inflammatory dermatosis affecting 0.2%-4.8% of the population worldwide causing a significant occupational, personal or psychosocial morbidity to these patients for life. The basic aim of psoriasis therapy is to control the disease to maximum possible extent and improve the patient’s quality of life. Management of triggers for flare-ups, lifestyle modifications, and dietary supplements are often recommended. Intermittent or rotational therapy with frequent alterations in treatment options is usually needed to reduce toxicity of anti-psoriatic drugs in the absence of safer alternatives. Currently, several biological agents categorized as either T-cell targeted (e.g., Alefacept, Efalizumab) or cytokine modulating (e.g., Adalimumab, Infliximab, Etanercept) are available for treating severe psoriasis. However, their high cost is often precluding for most patients. The usefulness of systemic (methotrexate, cyclosporine, acitretin or several other therapeutic agents) or topical (tar, anthralin, corticosteroids or calcipotriol ointments, phototherapy with or without psoralens) therapies has been well established for the management of psoriasis. The literature is also replete with benefits of less used non-standard and unconventional treatment modalities (hydroxycarbamide, azathioprine, leflunomide, mycophenolate mofetil, isotretinoin, fumarates, topical calcineurin inhibitors, peroxisome proliferator-activated receptors agonists, statins, sulfasalazine, pentoxifylline, colchicine, grenz ray therapy, excimer laser, climatotherapy and balneophototherapy, peritoneal dialysis, tonsillectomy, ichthyotherapy, etc.). These can be used alternatively to treat psoriasis patients who have mild/minimal lesions, are intolerant to conventional drugs, have developed side effects or achieved recommended cumulative dose, where comorbidities pose unusual therapeutic challenges, or may be as intermittent, rotational or combination treatment alternatives.
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