Impact of smoking on response to systemic treatment in patients with psoriasis: a retrospective case-control study
Impact of smoking on response to systemic treatment in patients with psoriasis: a retrospective case-control study
复制标题
DOI：
10.1111/bjd.13359
复制
发表时间：
2015-02-01
影响因子：
10.3
通讯作者：
Fernandez, A. P.
中科院分区：
文献类型：
--
作者：
Kinahan, C. E.;Mazloom, S.;Fernandez, A. P.
背景 吸烟是发生牛皮癣的一个公认的危险因素，并且与更严重疾病的发生有关。戒烟似乎不会导致牛皮癣的临床改善。银屑病患者吸烟是否会影响对全身治疗的反应尚不清楚。 目的 确定患有银屑病并伴有或不伴有银屑病关节炎的吸烟者对全身药物的反应是否与不吸烟者一样。 方法 我们对在我们机构就诊的伴有或不伴有银屑病关节炎的中重度银屑病患者进行了回顾性审查，这些患者要么是活跃吸烟者，要么是不吸烟者，并且 计算了系统治疗 3-16 个月后医生总体评估 (PGA) 评分的变化。我们还计算了每位患者尝试的全身治疗的平均次数。结果 66 名患者（46 名非吸烟者，20 名吸烟者）符合我们的纳入标准。吸烟者和非吸烟者之间基线和开始全身治疗后 3-16 个月的 PGA 评分变化没有显着差异，每位患者尝试的全身治疗的平均次数也没有显着差异。我们发现治疗后取得显着结果的患者百分比存在临界显着趋势，与每天吸烟 > 10 支香烟的患者相比，每天吸烟 < 10 支香烟的患者达到目标 PGA 分数的比例更高。我们研究的局限性包括其回顾性以及符合我们纳入标准的患者数量相对较少。结论在我们的回顾性研究队列中，吸烟并不影响银屑病患者对全身治疗的反应。有必要进行一项前瞻性研究，检查吸烟、牛皮癣和全身治疗反应之间的复杂关系，以更好地探讨这种关联。
Background Smoking is a well-established risk factor for developing psoriasis and is associated with development of more severe disease. Smoking cessation does not appear to result in clinical improvement of psoriasis. Whether smoking in patients with psoriasis impacts response to systemic therapy is unknown.Objectives To determine whether smokers with psoriasis with or without psoriatic arthritis respond to systemic agents as well as nonsmokers do.Methods We performed a retrospective review of patients with moderate-to-severe psoriasis with or without psoriatic arthritis seen at our institution, who were either active smokers or nonsmokers, and calculated changes in Physician's Global Assessment (PGA) scores after 3-16 months of systemic treatment. We also calculated the average number of systemic treatments tried per patient.Results Sixty-six patients (46 nonsmokers, 20 smokers) met our inclusion criteria. Changes in PGA scores between baseline and 3-16 months after initiation of systemic treatment did not significantly differ between smokers and nonsmokers, nor did the average number of systemic treatments tried per patient. We detected a borderline significant trend in the percentage of patients who had significant outcomes after treatment, with a higher percentage of patients smoking < 10 cigarettes daily achieving target PGA scores compared with those smoking > 10 cigarettes daily. Limitations of our study include its retrospective nature and the relatively small number of patients meeting our inclusion criteria.Conclusions 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.