Associations of Lifestyle-Related Factors and Psoriatic Arthritis Disease Activity: The Dutch South West Psoriatic Arthritis Study.

Abstract

This study aims to investigate lifestyle-related factors in patients with psoriatic arthritis (PsA) and their association with disease activity measurements. This multicenter cohort included 938 patients who were newly diagnosed with PsA between 2013 and 2023. A composite lifestyle risk score (range 0 to 5) was calculated using five lifestyle-related factors assessed at baseline (body mass index, waist circumference, smoking, alcohol consumption, physical activity). Higher scores indicate the presence of more lifestyle-related risk factors. One-year disease activity outcomes included PsA Disease Activity Score (PASDAS), disease activity in PsA (DAPSA), PASDAS and DAPSA low disease activity (LDA) and remission, and minimal disease activity (MDA). The rate of obesity was 33%, abdominal obesity was 51%, current smoking was 19%, and alcohol consumption was 72%, with 3% of patients physically inactive. Using multivariable analyses, a higher lifestyle risk score was associated with higher PASDAS (β 0.15; 95% confidence interval [CI] 0.08-0.23), and lower odds for achieving PASDAS-LDA (odds ratio [OR] 0.59; 95% CI 0.45-0.77), and MDA (OR 0.72; 95% CI 0.57-0.90) at one-year follow-up. Similar associations were observed for DAPSA (β 1.18; 95% CI 0.65-1.71) and DAPSA-LDA (OR 0.74; 95% CI 0.59-0.92). Analysis of individual factors showed that general obesity, abdominal obesity, and smoking were significantly associated with higher PASDAS and DAPSA and lower odds for achieving PASDAS-LDA and MDA. Lifestyle-related risk factors were prevalent in patients with PsA. The associations among lifestyle-related factors and PsA disease activity, mainly obesity and smoking, provide a foundation to address lifestyle in PsA care.