Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Smoking Is Negatively Associated with Development of Psoriatic Arthritis among Psoriasis Patients.

Eder3,  Lihi, Shanmugarajah3,  Sutha, Thavaneswaran3,  Arane, Chandran3,  Vinod, Cook1,  Richard, Gladman2,  Dafna D.

Department of Biostatistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
Toronto Western Hospital, Toronto, ON, Canada
University of Toronto Psoriatic Arthritis Clinic, Toronto Western Hospital, Toronto, ON, Canada


Smoking is a strong risk factor for seropositive rheumatoid arthritis. Smoking has also been associated with higher risk of psoriasis especially in patients with HLA-Cw6. There is no clear documentation of an association between smoking and PsA.


To determine whether smoking is associated with development of PsA among patients with psoriasis.


Data collected from two prospective cohorts, PsA and psoriasis uncomplicated with arthritis, was analyzed. In the psoriasis cohort, the presence of clinical inflammatory arthritis was ruled out by rheumatologic assessment. Smoking status was determined at the time of the diagnosis for PsA patients and at the first visit to the clinic for the psoriasis patients. Smoking status was defined as current or past smoker and lifetime non-smoker. A logistic regression model was constructed to determine the association between smoking status and PsA after adjusting for age, sex and duration of psoriasis. The prevalence of current smokers in each group was compared with data of smoking status in the general population from Statistics Canada through standardized prevalence ratios (SPRs).


791 PsA and 404 psoriasis patients were included in the study. The mean age and duration of psoriasis were: 46.3±13.1 and 16.1±14.1 years, respectively, for the PsA group and 36.7±13 and 8.5±10.2 years, respectively, for the psoriasis group. The proportions of females in the PsA and psoriasis groups were similar (41.6% vs. 43.8%, respectively). The proportion of lifetime non-smokers was higher compared to current smokers in the PsA group (54.7% vs. 43%, p<0.001), the proportion of past smokers was higher in the psoriasis group (30.2% vs. 23.4%, p=0.001). The number of pack years was similar in the psoriasis and the PsA patients (11.7±14 and 11.3±12.1 pack years respectively). On multivariate analysis after adjusting for age, sex and duration of psoriasis, current smoker status vs. lifetime non-smoker remained negatively associated with PsA (Odds Ratio (OR) 0.6, 95% Confidence Intervals (CI) 0.5–0.8, p=0.003), while past smoker vs. lifetime non-smoker status was no longer significantly associated with PsA (OR 0.8, 95% CI 0.6–1.1, p=0.2). The SPRs for current smoking for males with psoriasis and PsA were 1.12 (95% CI 1.00–1.26) and 1.0 (95% CI 0.91–1.11), respectively, while the SPRs for females with psoriasis and PsA were 1.29 (95% CI 1.12–1.47) and 1.18 (95% CI 1.13–1.23), respectively.


Active smoking is negatively associated with PsA among psoriasis patients. The prevalence of active smoking is higher in females with psoriasis and PsA compared to the general population.

To cite this abstract, please use the following information:
Eder, Lihi, Shanmugarajah, Sutha, Thavaneswaran, Arane, Chandran, Vinod, Cook, Richard, Gladman, Dafna D.; Smoking Is Negatively Associated with Development of Psoriatic Arthritis among Psoriasis Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1956
DOI: 10.1002/art.29721

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