Environmental risk factors for the development of psoriatic arthritis: results from a case-control study.
Ann Rheum Dis
; 67(5): 672-6, 2008 May.
Article
em En
| MEDLINE
| ID: mdl-17823200
ABSTRACT
OBJECTIVE:
To identify potential risk factors for the onset of inflammatory arthritis (IA) in a large cohort of patients with psoriatic arthritis (PsA) of recent onset.METHODS:
We recruited cases with psoriasis and an onset of IA within the past 5 years. Controls were patients who had psoriasis but no arthritis. We assessed potential factors associated with the development of IA using a detailed postal questionnaire. An unmatched analysis adjusted for age and gender was performed. Exposure was censored in the controls at a "dummy-date" assigned randomly in proportion to the percentage of cases developing IA in any given year.RESULTS:
We studied 98 cases and 163 controls. Exposures showing a positive association before the onset of IA in patients with psoriasis were rubella vaccination (OR (95% CI) = 12.4 (1.2 to 122)), injury sufficient to require a medical consultation (2.53 (1.1 to 6.0)), recurrent oral ulcers (4.2 (2.0 to 9.0)) and moving house (2.3 (1.2 to 4.4)). Cases were also more likely to have experienced a fractured bone requiring hospital admission (50% vs 9%, p = 0.040).CONCLUSIONS:
We found a number of environmental exposures associated with the onset of IA in subjects with psoriasis. The strongest associations were with trauma thereby adding to the hypothesis of a "deep Koebner phenomenon" in PsA. Our data also suggest that exposure of the immune system to certain infection-related triggers may also be of relevance. Further studies are needed to verify these observations and to examine potential immunological mechanisms that underlie them.
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Base de dados:
MEDLINE
Assunto principal:
Artrite Psoriásica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
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Pregnancy
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article