This article is more than 5 years old. Information may no longer be current.
Obesity, Smoking Linked WIth Reduced Likelihood of Sustained Remission in Patients With Early RA
Click Here to Manage Email Alerts
LONDON — Smoking and excess weight had significant independent and combined effects on the likelihood of achieving sustained remission among patients with rheumatoid arthritis, according to results presented at the EULAR Annual Congress.
“… The evidence would certainly point to the fact that stopping smoking is critically important, really important for everybody, but it may be especially important for people with [rheumatoid arthritis], and losing weight, especially if you are a woman, can make a difference,” said Susan Bartlett, PhD, of McGill University in Montreal.
Among 1,008 patients (72% women) with rheumatoid arthritis (RA) enrolled in the Canadian Early Arthritis Cohort (CATCH), Bartlett and colleagues found 74% of patients were treated with methotrexate, whereas 52% received steroids and 3% received a biologic at entry. Results showed 47% of men and 30% of women were overweight, 33% of men and women were obese and 20% of men and 15% of women smoked.
Susan Bartlett
Sustained remission was achieved in 38% of patients at 3 years with a median time to sustained remission of 11.3 months, according to results. Cox survival analysis showed sustained remission was significantly associated with BMI class and smoking, as well as a three-way interaction for BMI class, smoking and sex.
“If you were obese, you were about half as likely to make it to remission in the first 3 years of your diagnosis. If you were a woman, you were about two-thirds as likely as men to make it into remission, and if you were a smoker, you were also about two-thirds as likely,” Bartlett said. “But these factors seemed to work together because we found an interaction among smoking, weight and sex such that the very best rates of remission were found in men who were nonsmokers and had a healthy weight, and the very worst, unfortunately, were in women who were obese and who smoked.” – by Casey Tingle
Reference:
Bartlett SJ, et al. Abstract #OP0173. Presented at: EULAR Annual Congress; June 8-11, 2016; London.
Disclosure: Bartlett reports no relevant financial disclosures.
Perspective
Back to Top
João Eurico Fonseca, MD, PhD
This study confirms the relevance of an important risk factor for rheumatoid arthritis (RA) onset (smoking) as also being a factor that interferes with disease activity and, as such, with the overall prognosis of the disease. Obesity, being related with disturbances in immune and inflammatory pathways and also acting potentially on the metabolism of the drugs used for the treatment of rheumatoid arthritis, is depicted in this study as an additional factor interfering with clinical remission.
Obesity and smoking are recanting risk factors for cardiovascular disease, which is also associated with RA. Clinicians were already aware of the relevance of the control of these risk factors for the prevention and control of cardiovascular morbidity and mortality in these patients. Now, the importance of controlling these variables is even higher as they also can interfere with the control of disease activity and overall prognosis of the patient.
Click Here to Manage Email Alerts