Impact of smoking on response to systemic treatment in patients with psoriasis: a retrospective case-control study

Kinahan, Cristina; Mazloom, Sean; Fernandez, Anthony P.

doi:10.1111/bjd.13359

Cited by 18 publications

(21 citation statements)

References 39 publications

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“…The data from the cohort of patients with psoriasis for Germany and Switzerland analysed prospectively in this study confirms the results of previous prospective (35)(36)(37) and retrospective (38)(39)(40) studies, in demonstrating that active smoking does not significantly affect the treatment response of skin lesions in psoriasis to systemic therapies. Menter et al reported the absence of a correlation between active tobacco use and PASI 75 response in a prospective study with 814 patients treated with adalimumab (35).…”

Section: Discussionsupporting

confidence: 86%

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Smoking does not Alter the Therapy Response to Systemic Anti-psoriatic Therapies: A Two-country, Multi-centre, Prospective, Non-interventional Study

et al. 2019

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The German (PsoBest) and Swiss (SDNTT) Psoriasis Registries collect data on the efficacy of anti-psoriatic treatments among smokers and non-smokers. Out of 5,346 patients included in these registries, 1,264 met the inclusion criteria for this study. In the smoking group, 715 (60.6%) reached therapy response at month 3, compared with 358 (63.7%) in the non-smoking group. At month 6, 659 (74.1%) vs. 330 (77%), and at month 12, 504 (76.6%) vs. 272 (79.0%) reached therapy response. Therefore, these data do not show that smoking affects the response rate of anti-psoriatic therapy after 3, 6 and 12 months. Psoriasis can involve the skin, joints, nails and cardiovascular system and result in a significant impairment in quality of life. Studies have shown a lower response rate to systemic anti-sporiatic therapies in smokers, and smoking is a trigger factor for psoriasis. The aim of this study was therefore to analyse the response to systemic therapies for psoriasis, with a focus on smoking. Prospectively collected data from patients with moderate to severe psoriasis included in the national psoriasis registries for Germany and Switzerland (Pso-Best and SDNTT) were analysed. Therapy response was defined as reaching a Psoriasis Area and Severity Index (PASI) reduction of 75%, PASI ≤ 3 or Dermatology Life Quality Index (DLQI) ≤ 1. Out of 5,346 patients included in these registries, 1,264 met the inclusion criteria for this study. In the smoking group, 715 (60.6%) reached therapy response at month 3, compared with 358 (63.7%) in the non-smoking group (p ≤ 0.269), 659 (74.1%) vs. 330 (77%) reached therapy response at month 6 (p ≤ 0.097), and 504 (76.6%) vs. 272 (79.0%) at month 12 (p ≤ 0.611). Therefore, these data do not show that smoking affects the response rate of anti-psoriatic therapy after 3, 6 and 12 months.

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Section: Discussionsupporting

confidence: 86%

“…No difference between smoking status and efficacy of TNF-α blockers and ustekinumab was, however, found in a retrospective Italian study of 350 patients (39). A smaller retrospective study yielded similar results; however, only 36 non-smokers and 20 smokers met the inclusion criteria (38).…”

Section: Discussionmentioning

confidence: 83%

Smoking does not Alter the Therapy Response to Systemic Anti-psoriatic Therapies: A Two-country, Multi-centre, Prospective, Non-interventional Study

et al. 2019

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“…In this issue of the BJD , Kinahan et al . have investigated the effect of smoking on the response to systemic antipsoriatic treatment in a retrospective case–control study.…”

Section: Funding Sourcesmentioning

confidence: 99%

“…Based on the results obtained in the study by Kinahan et al ., it would be of value to perform a prospective study, with a preliminary sample size calculation and primary outcome measures, including more than one measure of disease severity, data on all potential confounders and possibly also patient‐reported outcome measures. The goal of this study would be to determine the influence of smoking on the response to specific systemic treatments, adjusting for known risk factors involved in psoriasis and to investigate whether there is a dose–response relationship with the degree of smoking and response to systemic treatment.…”

Section: Funding Sourcesmentioning

confidence: 99%

Lifestyle changes can make a difference in psoriasis

Dowlatshahi

2015

Br J Dermatol

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“…5 to 10% of body weight) increases the responsiveness of obese patients to any systemic treatments [62][63][64]. Smoking habit has been associated to onset and worsening of psoriasis, and smoking cessation can positively affect the disease course [65]. Patients with psoriasis exhibit a decreased level of physical activity, possibly for both psychological and physiological reasons [66].…”

Section: Management Of Patients With Moderate To Severe Psoriasis Andmentioning

confidence: 99%

Systemic therapy of psoriasis in diabetic patients

Gisondi¹,

Perazzolli²,

Giglio³

et al. 2015

Glob Dermatol

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Psoriasis is a chronic inflammatory skin disease affecting 2-3% of worldwide population. Moderate to severe psoriasis is frequently associated with metabolic disorders including diabetes, obesity, dyslipidaemia, metabolic syndrome and non-alcoholic fatty liver disease. In particular, the prevalence of diabetes in patients with psoriasis ranges from 5 to 54%. Most of the studies found that the prevalence of diabetes is higher in patients with moderate to severe psoriasis compared to mild disease. The association between psoriasis and diabetes could be explained considering several factors including a common genetic background, the high prevalence of metabolic risk factors for diabetes in patients with psoriasis as well as unhealthy life-styles such heavy drinking, over-eating and sedentary, which are common in patients with psoriasis. From a clinical prospective, the understanding of the patients in the context of metabolic comorbidities including diabetes is very important to ensure that treatment is tailored to meet the individual patient needs. Indeed, some pharmacological treatments may negatively affect metabolic comorbidities, and have important interactions with drugs that are commonly used to treat them. Non-pharmacological intervention such as diet and physical exercise could both improve the response to treatments for psoriasis and reduce the risk of diabetes and cardiovascular events.

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Impact of smoking on response to systemic treatment in patients with psoriasis: a retrospective case-control study

Abstract: In our retrospectively studied cohort, smoking did not affect response to systemic treatment in patients with psoriasis. A prospective study examining the complex relationship between smoking, psoriasis and response to systemic therapy is warranted to explore this association better.

Cited by 18 publications

References 39 publications

Smoking does not Alter the Therapy Response to Systemic Anti-psoriatic Therapies: A Two-country, Multi-centre, Prospective, Non-interventional Study

Smoking does not Alter the Therapy Response to Systemic Anti-psoriatic Therapies: A Two-country, Multi-centre, Prospective, Non-interventional Study

Lifestyle changes can make a difference in psoriasis

Systemic therapy of psoriasis in diabetic patients

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