A NEW study has explored the relationship between psoriasis and chronic obstructive pulmonary disease (COPD) to determine whether patients with psoriasis are at increased risk for developing COPD. The research, led by Lily Guo, Duke University School of Medicine, Durham, North Carolina, USA, utilised data from the National Health and Nutrition Examination Surveys database, to assess the prevalence of COPD among psoriasis patients.
The cohort comprised 7,029,160 patients over 20 years old, diagnosed with psoriasis. The group had a COPD prevalence of 9.64% while, in contrast, the prevalence of COPD in a group of psoriasis-free individuals was 6.94%.
To evaluate the incidence and risk of COPD, the research group identified 481,076 psoriasis patients and 43,624,233 psoriasis-free controls. The incidence of COPD in psoriasis patients was 10.74 cases per 1000 person-years, compared to 6.36 cases per 1000 person-years in the control group. Other findings were that psoriasis patients with a disease duration of less than five years exhibited a higher incidence of COPD than those with longer disease durations and, that female psoriasis patients had a higher incidence of COPD than their male counterparts.
Despite these findings, multivariable Cox regression analysis indicated no significant association between psoriasis and COPD development (hazard ratio: 0.99; 95 % CI: 0.98, 1.00; p=0.271). This suggests that while psoriasis patients exhibit higher prevalence and incidence rates of COPD, psoriasis is not an independent risk factor for COPD.
Smoking is a known risk factor for both conditions, and, considering psoriasis patients are more likely to smoke than psoriasis-free individuals, this could be one of the contributing factors to this correlation. The oxidative stress from cigarette smoke contributes to lung inflammation, leading to COPD. Therefore, the increased smoking rates among psoriasis patients likely drive the observed higher COPD prevalence and incidence.
This study highlights the higher prevalence and incidence of COPD among psoriasis patients but clarifies that psoriasis alone does not independently increase the risk of developing COPD. The findings emphasise the need to consider smoking behaviour when managing psoriasis patients with potential respiratory comorbidities.
Katie Wright, EMJ
Reference
Guo L et al. Prevalence, incidence, and risk of chronic obstructive pulmonary disease among psoriasis patients. Respir Med. 2024;231:107729.
