Study nixes link between high gluten and psoriasis, PsA, atopic dermatitis

  • Drucker AM & al.
  • J Am Acad Dermatol
  • 9 Aug 2019

  • International Clinical Digest
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Takeaway

  • The Nurses Health Study (NHS) II failed to find an association between high dietary gluten and new-onset psoriasis, psoriatic arthritis (PsA), or atopic dermatitis.

Why this matters

  • Findings do not support gluten as a modifiable risk factor for psoriasis, PsA, or atopic dermatitis.

Study design

  • The NHS II prospective cohort study included 85,185 participants for psoriasis, 85,324 for PsA, and 63,443 for atopic dermatitis analyses.
  • Dietary gluten was calculated from a Food Frequency Questionnaire given every 4 years (1991-2015 for psoriatic disease, 1995-2013 for atopic dermatitis).
  • To determine disease outcome, participants were asked about year of diagnosis every few years but no later than 2013, and disease onset was validated by medical records.
  • Funding: NIH; Brown University; Regeneron; Sanofi.

Key results

  • Multivariate analysis did not find an association between high (vs low) quintile of dietary gluten and:
    • Psoriasis: HR, 1.15; 95% CI, 0.98-1.36.
    • PsA: HR, 1.12; 95% CI, 0.78-1.62.
    • Atopic dermatitis: HR, 0.91; 95% CI, 0.66-1.25.

Limitations

  • Observational design.
  • No confirmation of dietary gluten.
  • No assessment of gluten and disease severity.