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Smoking cessation is associated with lower disease activity and predicts cardiovascular risk reduction in rheumatoid arthritis patients

Abstract: Objectives: Smoking is a major risk factor for the development of both cardiovascular disease (CVD) and RA and may cause attenuated responses to anti-rheumatic treatments. Our aim was to compare disease activity, CVD risk factors and CVD event rates across smoking status in RA patients. Methods: Disease characteristics, CVD risk factors and relevant medications were recorded in RA patients without prior CVD from 10 countries (Norway, UK, Netherlands, USA, Sweden, Greece, South Africa, Spain, Canada and Mexico). Information on CVD events was collected. Adjusted analysis of variance, logistic regression and Cox models were applied to compare RA disease activity (DAS28), CVD risk factors and event rates across categories of smoking status. Results: Of the 3311 RA patients (1012 former, 887 current and 1412 never smokers), 235 experienced CVD events during a median follow-up of 3.5 years (interquartile range 2.5-6.1). At enrolment, current smokers were more likely to have moderate or high disease activity compared with former and never smokers (P < 0.001 for both). There was a gradient of worsening CVD risk factor profiles (lipoproteins and blood pressure) from never to former to current smokers. Furthermore, former and never smokers had significantly lower CVD event rates compared with current smokers [hazard ratio 0.70 (95% CI 0.51, 0.95), P = 0.02 and 0.48 (0.34, 0.69), P < 0.001, respectively]. The CVD event rates for former and never smokers were comparable. Conclusion: Smoking cessation in patients with RA was associated with lower disease activity and improved lipid profiles and was a predictor of reduced rates of CVD events.

 Fuente: Rheumatology (Oxford) . 2020 Aug 1;59(8):1997-2004

 Editorial: Oxford University Press

 Año de publicación: 2020

 Nº de páginas: 8

 Tipo de publicación: Artículo de Revista

 DOI: 10.1093/rheumatology/kez557

 ISSN: 1462-0324,1462-0332

 Url de la publicación: https://www.doi.org/10.1093/rheumatology/kez557

Autoría

ROELSGAARD, IDA K.

IKDAHL, EIRIK

ROLLEFSTAD, SILVIA

WIBETOE, GRUNDE

ESBENSEN, BENTE A.

KITAS, GEORGE D.

RIEL, PIET VAN

GABRIEL, SHERINE

KVIEN, TORE K.

DOUGLAS, KAREN

WALBERG-JONSSON, SOLVEIG

RANTAPAA DAHLQVIST, SOLBRITT

KARPOUZAS, GEORGE

DESSEIN, PATRICK H.

TSANG, LINDA

EL-GABALAWY, HANI

HITCHON, CAROL A.

PASCUAL-RAMOS, VIRGINIA

CONTRERAS-YAÑEZ, IRAZU

SFIKAKIS, PETROS P.

SEMB, ANNE GRETE