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Study: Smoking affects men, women with RA differently
Men and women with rheumatoid arthritis appeared to be affected by smoking in different ways, according to recently published research.
Researchers studied patients from the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort, a large, observational cohort of patients with rheumatoid arthritis (RA) who have visited physicians at the Institute of Rheumatology in the Tokyo Women's Medical University since October 2000. Of the 810 men and 4,206 women who completed a questionnaire study in April 2011, 208 men and 314 women were smokers.
Among the patients studied, current male smokers were more likely to be older than female smokers (61.6 years vs. 56.7 years), have higher BMI (22.6 kg/m2 vs. 20.5 kg/m2) and more likely to have more circulating rheumatoid factor (93 IU/mL) vs. 77 IU/mL) than female smokers, all non-smokers and all former smokers, according to the researchers.
No significant differences were seen in disease activity score based on erythrocyte sedimentation rate (DAS28-ESR), the Japanese Health Assessment Questionnaire, the Simplified Disease Activity Index or the Clinical Disease Activity Index.
Logistical regression analysis revealed men who never smoked had the highest proportion of DAS28-ESR remission, but no differences in remission rates were seen in women regardless of smoking status. - by Shirley Pulawski
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Yet another study has demonstrated the ill effects of smoking in the presence of rheumatoid arthritis (RA). It has been known for decades that smoking is an epidemiologic risk, which latter was more clearly linked to carrying the shared epitope. Implicit in this observation now is that citrullinated proteins are likely binding to PACS antibodies in the lung and produce anti-citrullinated protein antibodies.
It is further interesting to note that early studies of risk of smoking in Europe were hard to duplicate in North America until the effects of dose (i.e., smoking pack years) were taken into account. It has been demonstrated that smoking not only lessens the chance of going into remission from non-biologics but also from biologics.
In this interesting epidemiologic study from Japan, researchers have described a more robust effect of past or current smoking on outcomes even after adjustment for a number of confounders. More provocative is this effect was more pronounced in men than women, where men nonsmokers were more likely to achieve remission. Unfortunately, the critical issue is dose of smoking. Since this is an association, there are numerous lifestyle issues one would consider in an adult population of Japanese men and women that would likely differ, such as diet, exercise and alcohol. However, the message is still clear – smoking is bad for RA.