OBJECTIVE: To compare potential risk factors for the diagnosis of psoriatic arthritis (PsA), psoriasis, rheumatoid arthritis (RA), and ankylosing spondylitis (AS).
METHODS: Four parallel case-control studies were conducted within The Health Improvement Network using data between 1994 and 2015. Patients with PsA, psoriasis, RA, or AS were identified using validated code lists and matched to controls on age, sex, practice, and year. Risk factors were selected in the time prior to diagnosis. Multivariable logistic regression models were constructed for each disease using automated stepwise regression to test potential risk factors.
RESULTS: Patients with incident PsA (N=7,594), psoriasis (N=111,375), RA (N=28,341), and AS (N=3, 253) were identified and matched to 75,930, 1,113,345, 282,226, and 32,530 controls, respectively. Median diagnosis age was 48 (IQR 38-59), 41 (31-54), 43 (31-54), and 60 (48-71), respectively. In multivariable models, there were some shared and some differing risk factors across all 4 diseases: PsA was associated with obesity, pharyngitis, and skin infections; PsA and psoriasis were associated with obesity and moderate alcohol intake; PsA and AS were associated with uveitis; and PsA and RA were associated with preceding gout. Both RA and AS were associated with current smoking, former moderate drinking, anemia, osteoporosis, and inflammatory bowel disease. All shared former or current smoking as a risk factor; statin use was inversely associated with all 4 diseases.
CONCLUSION: Shared and different risk factors for PsA, psoriasis, RA, and AS were identified. Statin use was inversely associated with all 4 conditions.
|組織名||Perelman School of Medicine, University of Pennsylvania, Philadelphia,;Pennsylvania, United States; Department of Medicine/Rheumatology, University of;Iceland and Landspitali, Reykjavik, Iceland; Department of Biostatistics,;Epidemiology and Informatics, Perelman School of Medicine, University of;Pennsylvania, Philadelphia, Pennsylvania, United States; Department of;Medicine/Rheumatology, Boston University, Boston, Massachusetts, United States;;Department of Dermatology, Perelman School of Medicine, University of;Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania,;Philadelphia, Pennsylvania, United States. Source of Support: This work was;supported in part by NIH K23 AR063764 (PI Ogdie) and internal funds from the;University of Pennsylvania. Maureen Dubreil was supported by NIH K23 AR06912701.;Conflict of Interest: Elana Meer, Telma Thrastardottir, Maureen Dubreuil, Xingmei;Wang, and Yong Chen report no conflicts of interest. Joel Gelfand served as a;consultant for BMS, Boehringer Ingelheim, Lilly, Janssen Biologics, Novartis;Corp, UCB (DSMB), Neuroderm (DSMB), Dr. Reddy's Labs, Pfizer Inc., and Sun;Pharma, receiving honoraria; receives research grants (to the Trustees of the;University of Pennsylvania) from Abbvie, Boehringer Ingelheim, Janssen, Novartis;Corp, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for;continuing medical education work related to psoriasis that was supported;indirectly by Lilly, Ortho Dermatologics, and Novartis. Dr. Gelfand is a;co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma. Dr.;Gelfand is a Deputy Editor for the Journal of Investigative Dermatology receiving;honoraria from the Society for Investigative Dermatology and is a member of the;Board of Directors for the International Psoriasis Council, receiving no;honoraria. Thorvardur Love has received reimbursement from Celgene for speaking;about guidelines for the treatment of psoriatic arthritis. Alexis Ogdie has;served as a consultant for Abbvie, Amgen, BMS, Celgene, Corrona, Global Health;Living Foundation, Janssen, Lilly, Novartis, Pfizer, and Takeda and has received;grants to the University of Pennsylvania from Pfizer and Novartis and to Forward;from Amgen. Her husband has received royalties from Novartis. Corresponding;Author: Alexis Ogdie, MD MSCE, University of Pennsylvania, Division of;Rheumatology, 3400 Civic Center Blvd., Philadelphia, Pennsylvania 19104;;firstname.lastname@example.org.|