TY - JOUR
T1 - Smoking cessation is associated with lower disease activity and predicts cardiovascular risk reduction in rheumatoid arthritis patients
AU - Roelsgaard, Ida K.
AU - Ikdahl, Eirik
AU - Rollefstad, Silvia
AU - Wibetoe, Grunde
AU - Esbensen, Bente A.
AU - Kitas, George D.
AU - Van Riel, Piet
AU - Gabriel, Sherine
AU - Kvien, Tore K.
AU - Douglas, Karen
AU - Wållberg-Jonsson, Solveig
AU - Rantapää Dahlqvist, Solbritt
AU - Karpouzas, George
AU - Dessein, Patrick H.
AU - Tsang, Linda
AU - El-Gabalawy, Hani
AU - Hitchon, Carol A.
AU - Pascual-Ramos, Virginia
AU - Contreras-Yáñez, Irazú
AU - Sfikakis, Petros P.
AU - González-Gay, Miguel A.
AU - Crowson, Cynthia S.
AU - Semb, Anne Grete
N1 - Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - behaviour
KW - epidemiology
KW - outcome measures
KW - quality of life
KW - rheumatoid arthritis
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U2 - 10.1093/rheumatology/kez557
DO - 10.1093/rheumatology/kez557
M3 - Article
C2 - 31782789
AN - SCOPUS:85083013049
SN - 1462-0324
VL - 59
SP - 1997
EP - 2004
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 8
ER -