Factors that might influence response to systemic treatment for moderate-to-severe psoriasis are varied, and generally, are poorly understood, aside from high body weight, suggesting that other unidentified factors may be relevant in determining response to treatment. The impact of alcohol misuse on treatment response has not been previously investigated.
A group of researchers from the U.K conducted a study to investigate whether alcohol misuse is associated with poor response to treatment for psoriasis.
This was a prospective cohort study in which response to systemic therapies was assessed using the Psoriasis Area and Severity Index (PASI). The CAGE (Cut down, Annoyed, Guilty, Eye-opener) questionnaire was used to screen for alcohol misuse. A multivariable factional polynomial linear regression model was used to examine factors associated with a change in PASI between baseline and follow-up.
The results of the study are as follows:
· The cohort comprised 266 patients.
· For the entire cohort, the median PASI improved from 13 at baseline to 3 during follow-up.
· A higher CAGE score; obesity; and receiving a conventional systemic rather than a biologic therapy was significantly associated with poor response to treatment; whereas a higher baseline PASI was associated with a better response to treatment.
Thus, the researchers concluded that the poor response to therapy associated with alcohol misuse and obesity found in people with psoriasis calls for lifestyle behaviour change interventions and support as part of routine clinical care. Targeting interventions to prevent, detect and manage alcohol misuse among people with psoriasis is needed to minimize adverse health consequences and improve treatment response.
Reference:
Alcohol misuse is associated with poor response to systemic therapies for psoriasis: findings from a prospective multicentre cohort study by Iskandar I et. al published in the British Journal of Dermatology.
https://doi.org/10.1111/bjd.20577
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