According to recent results, the risk for incident Crohn’s disease was heightened among women with psoriasis, particularly those with concomitant psoriatic arthritis.
Researchers evaluated data from 174,476 women enrolled in the Nurses’ Health Study (NHS; n=78,211, assessed from 1996 to 2008) and NHS II (n=96,265, from 1991 to 2007).
History of psoriasis and psoriatic arthritis and the presence of Crohn’s disease (CD) or ulcerative colitis (UC) were determined in each case.
Incident CD occurred in 188 cases (72 from NHS and 116 from NHS II), and there were 240 incident UC cases (74 from NHS and 166 from NHS II). Psoriasis was present in 1,402 NHS participants and 1,353 of those in NHS II, with an additional 512 NHS participants and 1,122 in NHS II reporting psoriasis during follow-up.
Multivariate analysis indicated that psoriasis was significantly associated with CD in the NHS (RR=4.05; 95% CI, 1.75-9.38) and NHS II cohorts (RR=3.76; 95% CI, 1.82-7.74), as well as in pooled analysis (RR=3.86; 95% CI, 2.23-6.67). No significant association was observed between UC and psoriasis (RR=1.17; 95% CI, 0.41-3.36 in pooled analysis).
Patients with concomitant psoriasis and psoriatic arthritis were at particularly increased risk for CD (RR=6.54; 95% CI, 2.07-20.65). Other factors associated with increased CD risk included patients with psoriasis diagnosed before age 40, or those with duration of at least 10 years.
The researchers concluded,“Our prospective study demonstrates that women with psoriasis and PsA are at a significantly elevated risk of CD, providing evidence that these diseases may have common underlying pathogenic mechanisms. Moreover, we did not observe a significantly increased risk of UC associated with psoriasis, suggesting that psoriasis may share fewer overlapping pathways with UC compared with CD. Further understanding of the mechanisms that mediate the diseases could eventually lead to elucidation of new targets for interventions that may modulate their incidence or their activity.”
Disclosure: See the study for a full list of relevant disclosures.
11 June 2013