Stefán Már Thorarensen1, Na Lu2,3, Alexis Ogdie4, Joel M Gelfand5, Hyon K Choi6,7, Thorvardur Jon Love8,9. 1. Division of Public Health, Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2. Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA. 3. Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. 4. Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 5. Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 6. Department of Rheumatology, Harvard Medical School, Massachusetts, USA. 7. Department of Clinical Epidemiology, Massachusetts General Hospital, Boston, Massachusetts, USA. 8. Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 9. Department of Science, Landspitali University Hospital, Reykjavik, Iceland.
Abstract
OBJECTIVES: To evaluate the risk of psoriatic arthritis (PsA) among patients with psoriasis exposed to physical trauma. METHODS: A matched cohort study was performed using data from The Health Improvement Network (THIN). Patients with psoriasis exposed to trauma were randomly matched to up to five unexposed psoriasis controls based on gender, age, duration of psoriasis and the date of entry into THIN. Trauma exposure was stratified into subgroups of joint, bone, nerve and skin trauma. Cox proportional hazard models were used to estimate the HRs for developing PsA. For comparison, an identical analysis was performed in the entire THIN population evaluating rheumatoid arthritis (RA) risk following physical trauma. RESULTS: Patients with psoriasis exposed to trauma (N=15 416) and matched unexposed patients (N=55 230) were followed for a total of 425 120 person-years during which 1010 incident PsA cases were recorded. Adjusting for potential confounders, patients with psoriasis exposed to trauma had an increased risk of PsA compared with controls, with a multivariate HR of 1.32 (95% CI 1.13 to 1.54). In our subset analysis, bone and joint trauma were associated with multivariate HRs of 1.46 (95% CI 1.04 to 2.04) and 1.50 (95% CI 1.19 to 1.90), respectively; while nerve and skin trauma were not associated with a statistically significant increase in risk compared with controls. Patients exposed to trauma in the entire THIN population did not have an increased risk of developing RA: HR 1.04 (95% CI 0.99 to 1.10). CONCLUSIONS: Patients with psoriasis exposed to physical trauma are at an increased risk of developing PsA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: To evaluate the risk of psoriatic arthritis (PsA) among patients with psoriasis exposed to physical trauma. METHODS: A matched cohort study was performed using data from The Health Improvement Network (THIN). Patients with psoriasis exposed to trauma were randomly matched to up to five unexposed psoriasis controls based on gender, age, duration of psoriasis and the date of entry into THIN. Trauma exposure was stratified into subgroups of joint, bone, nerve and skin trauma. Cox proportional hazard models were used to estimate the HRs for developing PsA. For comparison, an identical analysis was performed in the entire THIN population evaluating rheumatoid arthritis (RA) risk following physical trauma. RESULTS:Patients with psoriasis exposed to trauma (N=15 416) and matched unexposed patients (N=55 230) were followed for a total of 425 120 person-years during which 1010 incident PsA cases were recorded. Adjusting for potential confounders, patients with psoriasis exposed to trauma had an increased risk of PsA compared with controls, with a multivariate HR of 1.32 (95% CI 1.13 to 1.54). In our subset analysis, bone and joint trauma were associated with multivariate HRs of 1.46 (95% CI 1.04 to 2.04) and 1.50 (95% CI 1.19 to 1.90), respectively; while nerve and skin trauma were not associated with a statistically significant increase in risk compared with controls. Patients exposed to trauma in the entire THIN population did not have an increased risk of developing RA: HR 1.04 (95% CI 0.99 to 1.10). CONCLUSIONS:Patients with psoriasis exposed to physical trauma are at an increased risk of developing PsA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Charlotte O'Brien-Gore; Elizabeth H Gray; Lucy E Durham; Leonie S Taams; Bruce W Kirkham Journal: Curr Rheumatol Rep Date: 2021-04-28 Impact factor: 4.592
Authors: Uyen-Sa D T Nguyen; Yuqing Zhang; Na Lu; Qiong Louie-Gao; Jingbo Niu; Alexis Ogdie; Joel M Gelfand; Michael P LaValley; Maureen Dubreuil; Jeffrey A Sparks; Elizabeth W Karlson; Hyon K Choi Journal: Ann Rheum Dis Date: 2017-11-04 Impact factor: 19.103