Shen Fanlingzi, Song Yu, Qiang Yan, Gao Xiangjin, Li Siyuan, Zhang Rui, Gao Zhongzhi, Li Bin, Jiang Wencheng, Wang Ruiping
Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Psoriasis (Auckl). 2024 Sep 23;14:103-114. doi: 10.2147/PTT.S484609. eCollection 2024.
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.
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.
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: 5.2611.49) and drinking (OR=5.21, 95% CI: 3.298.27) had higher risk of experiencing the failure to achieve PASI 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 PASI 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.
Tobacco smoking and alcohol drinking could increase the failure of PASI 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.
吸烟和饮酒与银屑病的患病率及疾病严重程度呈正相关。关于吸烟和饮酒对银屑病治疗效果影响的研究仍然有限，尤其是它们的交互作用。本研究旨在探讨吸烟和饮酒对银屑病患者治疗效果的交互作用。
2021年至2022年，我们从上海市皮肤病医院招募了560例银屑病患者。通过问卷调查和体格检查，在患者第0周、第4周和第8周就诊时收集人口统计学和临床特征以及治疗效果。采用逻辑回归模型探讨吸烟和饮酒对银屑病患者治疗效果的影响，并采用相乘和相加交互作用模型验证吸烟和饮酒对治疗效果的交互作用。
银屑病患者中吸烟和饮酒的患病率分别为43.8%和25.4%，其中19.6%的患者既吸烟又饮酒。逻辑回归分析显示，即使在调整混杂因素后，吸烟（OR=7.78，95%CI：5.2611.49）和饮酒（OR=5.21，95%CI：3.298.27）的患者在第8周未达到银屑病面积和严重程度指数（PASI）改善的风险更高。此外，相乘模型和相加模型均显示吸烟与饮酒存在交互作用，对治疗效果的影响更严重（OR=12.74，95%CI：7.16~22.67）。女性患者（OR=19.54）、使用甲氨蝶呤的患者（OR=28.31）和使用生物制剂的患者（OR=21.61）达到PASI改善的比例更易受到吸烟和饮酒的影响。
吸烟和饮酒会增加银屑病患者未达到PASI改善的几率，无论是单独作用还是交互作用。我们建议皮肤科医生应教育患者注意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。
