Ambient Temperature and Psoriatic Arthritis Odds Among Patients With Psoriasis: A Cross-sectional Analysis

Background: Although there has been growing interest in better understanding risk factors for progression from psoriasis (PsO) to psoriatic arthritis (PsA), research on the role of ambient temperature in potentiating PsA risk has been limited. We sought to evaluate the association of average-annual ambient temperature exposure with prevalent PsA diagnosis among a large cohort of US adults with PsO. Methods: We studied electronic health record-data from participants with PsO, with and without an associated PsA diagnosis, who enrolled in the National Institutes of Health's All of Us Research Program between May 31, 2017, and July 1, 2022. Average-annual ambient temperature exposure data was obtained from the National Oceanic and Atmospheric Administration. Multivariable logistic regression analysis was utilized to assess the association between three-digit Zone Improvement Plan (ZIP) code-level ambient temperatures and prevalent PsA diagnosis, controlling for patient age, sex, body mass index, smoking history, race and ethnicity, income, urbanicity, and community deprivation. Results: In this cohort of 5466 patients with PsO (mean age [SD], 61.86 years [15.45 years]; 3153 females [57.7%]) and 1080 patients with both PsO and PsA (mean age [SD], 60.76 years [13.48 years]; 665 females [61.6%]), each 1°F increase in average-annual ambient temperature was associated with 2% increased odds of prevalent PsA diagnosis (adjusted odds ratio [aOR], 1.02; 95% CI, 1.01-1.03). Conclusion: Our study provides data to support further investigation of long-term, warmer ambient temperature exposure as a potential risk factor for PsA among those with PsO.