Objective To investigate the efficacy of adalimumab in the treatment of moderate and severe psoriasis and the influence of smoking on the efficacy of adalimumab in the treatment of psoriasis,and whether smoking can predict the response of adalimumab in the treatment of psoriasis.Methods Seventy-four patients with moderate to severe psoriasis(current smokers=17,non-smokers=57)who received adalimumab in the first cycle of treatment.PASI scores were performed by filling in questionnaires and followed up every 4 weeks.Results ①The PASI score of current smoking patients was 15.4(13.4,26.0)significantly higher than that of non-smoking patients 11.8(7.2,17.1),and the difference was statistically significant.②The number of patients with PASI50 and PASI75 with the increase of the number of times of adalimumab treatment for 4,8,and 12 weeks gradually increased.The results of PASI50 and PASI75 were used as dependent variable Logistic regression analysis,P=0.039＜0.05(OR=4.333),P=0.045＜0.05(OR=3.15),the model was established,and current smoking had a negative impact on PASI50 and PASI75.③The effective rate was 64.7％in smoking patients and 84.2％in non-smoking patients.The effect of non-smoking patients was significantly better than that of smoking patients(P=0.042＜0.05),and the difference was statistically significant.Conclusions ①The severity of psoriasis in smoking patients is higher.②Adalimumab is effective in the treatment of moderate and severe psoriasis.③In the treatment of moderate and severe psoriasis with adalimumab,there was a significant difference in the efficacy of smoking and non-smoking groups,and smoking was negatively correlated with the efficacy.
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