Tobacco Smoking Interacted with Alcohol Drinking Could Increase the Failure of PASI75 Achievement at Week 8 Among Patients with Psoriasis: Findings Based on a Psoriasis Cohort.

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI:10.2147/PTT.S484609
Fanlingzi Shen, Yu Song, Yan Qiang, Xiangjin Gao, Siyuan Li, Rui Zhang, Zhongzhi Gao, Bin Li, Wencheng Jiang, Ruiping Wang
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Abstract

Purpose: Tobacco smoking and alcohol drinking are positively associated with psoriasis prevalence and disease severity. Researches focusing on the influence of smoking and drinking on the treatment efficacy of psoriasis are still limited, especially their interaction effect. This study aims to explore the interactive effects of smoking and drinking on the treatment efficacy in psoriasis patients.

Patients and methods: From 2021 to 2022, we recruited 560 patients with psoriasis from Shanghai Skin Diseases Hospital. Demographic and clinical features as well as treatment efficacy were collected through questionnaire interview and physical examination during patient's hospital visit at week 0, week 4 and week 8. Logistic regression model was used to explore the influence of smoking and drinking on the treatment efficacy in psoriasis patients, and multiplicative and additive interaction models were used to verify the interaction effect of smoking and drinking on the treatment efficacy.

Results: The prevalence of smoking and drinking among psoriasis patients was respectively 43.8% and 25.4%, and 19.6% of them with both smoking and drinking. Logistic regression analysis showed that patients with smoking (OR=7.78, 95% CI: 5.26~11.49) and drinking (OR=5.21, 95% CI: 3.29~8.27) had higher risk of experiencing the failure to achieve PASI75 at week 8, even with the adjustment of confounders. Moreover, multiplicative as well as additive model showed that tobacco smoking interacted with alcohol drinking which influenced the treatment efficacy more severely (OR=12.74, 95% CI: 7.16~22.67). The proportion of PASI75 achievement in female patients (OR=19.54) and patients with methotrexate (OR=28.31) and biologics (OR=21.61) were more likely being affected by smoking and drinking.

Conclusion: Tobacco smoking and alcohol drinking could increase the failure of PASI75 achievement in patients with psoriasis, individually and interactively. We recommend that dermatologists should educate patients to pay attention to the negative effects of smoking and drinking, encourage them to quit, and thus improve the treatment efficacy.

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吸烟与饮酒相互作用会增加银屑病患者第 8 周 PASI75 达标的失败率:基于牛皮癣队列的研究结果。
目的:吸烟和饮酒与银屑病发病率和疾病严重程度呈正相关。有关吸烟和饮酒对银屑病疗效影响的研究仍然有限,尤其是它们之间的交互作用。本研究旨在探讨吸烟和饮酒对银屑病患者疗效的交互影响:2021年至2022年,我们在上海市皮肤病医院招募了560名银屑病患者。在第 0 周、第 4 周和第 8 周的医院就诊期间,通过问卷调查和体格检查收集了患者的人口统计学特征、临床特征和治疗效果。采用逻辑回归模型探讨吸烟和饮酒对银屑病患者疗效的影响,并采用乘法和加法交互模型验证吸烟和饮酒对疗效的交互作用:结果:银屑病患者吸烟和饮酒的比例分别为43.8%和25.4%,其中19.6%的患者同时吸烟和饮酒。逻辑回归分析表明,即使调整了混杂因素,吸烟(OR=7.78,95% CI:5.26~11.49)和饮酒(OR=5.21,95% CI:3.29~8.27)的患者在第8周未能达到PASI75的风险更高。此外,乘法和加法模型显示,吸烟与饮酒相互作用,对疗效的影响更大(OR=12.74,95% CI:7.16~22.67)。女性患者达到 PASI75 的比例(OR=19.54)、使用甲氨蝶呤(OR=28.31)和生物制剂(OR=21.61)的患者更容易受到吸烟和饮酒的影响:结论:吸烟和饮酒会单独或共同增加银屑病患者 PASI75 的失败率。我们建议皮肤科医生教育患者重视吸烟和饮酒的负面影响,鼓励他们戒烟戒酒,从而提高治疗效果。
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