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Clinical and epidemiological research
Extended report
Psoriasis, psoriatic arthritis and risk of gout in US men and women
  1. Joseph F Merola1,2,
  2. Shaowei Wu1,
  3. Jiali Han1,3,4,5,
  4. Hyon K Choi3,6,
  5. Abrar A Qureshi1,3
  1. 1Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
  2. 2Division of Rheumatology, Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
  3. 3Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
  4. 4Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana, USA
  5. 5Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  6. 6Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Abrar A Qureshi, Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy St Providence, RI 02903, USA; abrar_qureshi{at}brown.edu

Abstract

Background and objective Individuals with psoriasis have increased blood levels of uric acid. However, there is no prospective data on the association between psoriasis and uric acid levels and subsequent development of gout. In this study, we examined the risk of gout among individuals with psoriasis and psoriatic arthritis (PsA) in two cohorts of men and women, the Health Professionals Follow-up Study (HPFS) (1986–2010) and Nurses’ Health Study (NHS) (1998–2010).

Methods 27 751 men and 71 059 women were included in the analysis. Lifetime history of physician-diagnosed incident psoriasis and PsA was confirmed by validated supplementary questionnaires. Incident gout diagnoses were confirmed based on the American College of Rheumatology survey criteria. We used Cox proportional hazards models controlling for potential risk factors to calculate the HRs with 95% CIs of incident gout while simultaneously adjusting for several common risk factors.

Results We documented 2217 incident cases of gout during follow-up. Psoriasis was associated with an increased risk of subsequent gout with a multivariate HR of 1.71 (95% CI 1.36 to 2.15) in the pooled analysis. Risk of gout was substantially augmented among those with psoriasis and concomitant PsA (pooled multivariate HR: 4.95, 95% CI 2.72 to 9.01) when compared to participants without psoriasis.

Conclusions In this prospective study of US women and men, psoriasis and PsA were associated with an increased risk of gout.

  • Psoriatic Arthritis
  • Gout
  • Epidemiology

https://doi.org/10.1136/annrheumdis-2014-205212

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