Objectives In this systematic literature review and meta-analysis, we aimed to investigate the impact of cigarette smoking on the prevalence and incidence of psoriasis and psoriatic arthritis (PsA). Method We performed a systematic literature review using the MEDLINE, EMBASE and Cochrane Central Register databases. The literature included publications from January 1980 to July 2019. The studies that provided clear information on the number of patients with ever smoking data were included in the meta-analysis. Results The systematic literature review identified 52 and 24 articles for the prevalence of smoking in psoriasis and PsA, respectively. Of these, 16 articles on psoriasis and three and four (general population and psoriasis, respectively) articles on PsA met the criteria and were included in the meta-analysis. The prevalence of ever smoking was increased in psoriasis compared with the general population (OR: 1.84; 95% CI: 1.4, 2.3). For PsA the prevalence of ever smoking was reduced in psoriasis patients (OR: 0.70; 95% CI: 0.60, 0.81), but not changed compared with the general population (OR: 1.10; 95% CI: 0.92, 1.32). Conclusion This meta-analysis showed that ever smoking increases the risk of psoriasis in the general population, but may reduce the risk of PsA in psoriasis patients. The latter may be also due to the collider effect. Whether smoking cessation neutralizes the risk of developing psoriasis requires a well-defined smoking data collection for the past history and this is currently unavailable in the literature.

Objective To investigate the occurrence of venous thromboembolic events (VTE) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, Turkey, Russia, UK, and North America. Methods Patients with a definite diagnosis of AAV who were followed for at least 3 months and had sufficient documentation were included. Data on VTE, including either deep vein thrombosis or pulmonary embolism, were collected retrospectively from tertiary vasculitis centers. Univariate and multivariate regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Over a median follow up of 63 (29; 101) months, VTE occurred in 278 (9.7%) of 2869 AAV patients with a similar frequency across different countries (from 6.3% to 13.7%), and AAV subtype (granulomatosis with polyangiitis: 9.8%; 95% CI 8.3–11.6, microscopic polyangiitis: 9.6%; 95% CI 7.9–11.4, and eosinophilic granulomatosis with polyangiitis: 9.8%; 95% CI 7.0–13.3). Most VTE (65.6%) were reported in the first-year post diagnosis. Multiple factor logistic regression analysis adjusted for sex and age showed that skin (OR 1.71, 95% CI 1.01–2.92), pulmonary (OR 1.78, 95% CI 1.04–3.14) and kidney involvement (eGFR 15–60 mL/min/1.73 m2, OR 2.86, 95% CI 1.27–6.47; eGFR < 15 mL/min/1.73 m2, OR 6.71, 95% CI 2.94–15.33) were independent variables associated with a higher occurrence of VTE. Conclusion Two thirds of VTE occurred during the initial phase of active disease. We confirmed previous findings from smaller studies that a decrease in kidney function, skin involvement and pulmonary disease are independently associated with VTE.

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ObjectiveTo investigate the occurrence of cardiovascular events (CVE) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, China, Turkey, Russia, UK, and USA.MethodsPatients with a definite diagnosis of AAV who were followed ≥3 months and had sufficient documentation were included. Data on myocardial infarction (MI) and stroke were collected retrospectively from tertiary vasculitis centers. Univariate and multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs.ResultsOver a median follow-up of 62 (interquartile range: 23, 100) months, CVE (mostly MI) occurred in 245 (10.7%) of 2286 AAV patients with a higher frequency in China and the UK. On multivariate regression analysis, older age (55-64.9 years; HR 2.93, 95% CI: 1.99, 4.31), smoking (HR 1.98, 95% CI: 1.48, 2.64), Chinese origin (HR 4.24, 95% CI: 3.07, 5.85), pulmonary (HR 1.50, 95% CI: 1.09, 2.06) and kidney (HR 3.02, 95% CI: 2.08, 4.37) involvement were independent variables associated with a higher occurrence of CVE.ConclusionWe showed that geographic region and both traditional and disease specific (kidney involvement in particular) factors were independently associated with CVE. Proper assessment and management of modifiable cardiovascular risk factors are essential for prevention of cardiovascular morbidity in AAV patients.