Smoking and the ACR 2015 Meeting in San Francisco

I cannot discuss all the 25 studies on smoking in detail, which were presented at the ACR 2015 Annual Meeting in San Francisco, but I have selected a few and will summarize the others. Effects on pain are seen with and without concomitant inflammation. So we see worsening in inflammatory rheumatic diseases as well as in fibromyalgia.

Adam Schiffenbauer and colleagues looked at smoking and the development of mysitis antibodies. Conclusion: “These data suggest that in Caucasians smoking is a risk factor for developing ILD, as well as anti-Jo-1 Abs and ASA, but is protective for anti-TIF-1, -Mi-2, and -MJ Abs.”Interestingly they didn’t find this impact in African Americans.

Jasvinder A. Singh and colleagues presented a study on “Perioperative Interventions for Smoking Cessation in Hip and Knee Arthroplasty for Osteoarthritis and Other Non-Traumatic Diseases”. They’ve concluded: “With an overall high grade of evidence, Perioperative smoking cessation therapy is significantly more efficacious than placebo in preventing incidence of complications after knee or hip replacement.”

Karin Magnusson and colleagues’ study: “Smoking and Alcohol Use Are Associated with Structural and Inflammatory Hand Osteoarthritis Features in a Population Based Study”. The authors come to a rather irritating conclusion: “Our results suggest a protective effect of smoking on radiographic hand OA whereas alcohol consumption may increase the risk of joint inflammation in hand OA.”

Axel Finckh1and colleagues  Inform us on: “The Impact of Tobacco Smoking on the Effectiveness of Abatacept in Rheumatoid Arthritis: […]”.Conclusion: “Data from this Pan-European registry analysis suggest that smoking is associated with a decreased effectiveness of ABA, with higher discontinuation rates and lower response rates, as has previously been reported for methotrexate and anti-TNF agents.”

Daniel Wendling and colleagues presented this study: “ASDAS-Based Remission Was Less Frequent Than Basdai-Based Remission, and Both Were Related to CRP and Smoking in Early Axial Spondyloarthritis”. Conclusion: “[…] smoking appears as a major marker of disease activity and remission in early AxSpA.”

Kristina SCHREIBER and colleagues concluded from their study: “Current and past smocking is associated with an increased disease activity (BASDAI and ASDAS-CRP respectively) and functional impairment. Pathogenesis remains to be determined. Smoking cessation should be encouraged in axSpA although these results suggest that it may not impact disease prognosis.”

Jeffrey A. Sparks and colleagues: “Smoking Behavior Changes after Rheumatoid Arthritis Diagnosis and Risk of Mortality during 36 Years of Prospective Follow-up”. They concluded: “Despite the known harmful effects of smoking in chronic diseases, only 16% of smokers quit after diagnosis with RA and maintained smoking cessation during follow-up. Smoking >5 pack-years after RA diagnosis was associated with increased mortality, independent of smoking before RA diagnosis. Interventions promoting cessation of smoking for patients newly diagnosed with RA may diminish the excess mortality of RA.”

Patricia P. Katz and colleagues on: “Impact of Smoking on Patient-Reported Disease Status and Symptoms Among Women with Lupus”. Conclusion: “While current smoking was not common, it was associated with significantly worse patient assessments of lupus status and worse symptoms. […].”

These and other studies underline the importance to actively promote the cessation of smoking in all of patients, who are treated in rheumatology.

References:

Schiffenbauer A, Smith N, Rider LG, Miller FW. Tobacco Smoking in Different Racial Groups Is Differentially Associated with the Development of Myositis Autoantibodies and Interstitial Lung Disease in the Idiopathic Inflammatory Myopathies [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/tobacco-smoking-in-different-racial-groups-is-differentially-associated-with-the-development-of-myositis-autoantibodies-and-interstitial-lung-disease-in-the-idiopathic-inflammatory-myopathies/. Accessed November 15, 2015.

Bharat A, Singh JA. Perioperative Interventions for Smoking Cessation in Hip and Knee Arthroplasty for Osteoarthritis and Other Non-Traumatic Diseases [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/perioperative-interventions-for-smoking-cessation-in-hip-and-knee-arthroplasty-for-osteoarthritis-and-other-non-traumatic-diseases/. Accessed November 15, 2015.

Magnusson K, Mathiessen A, Hammer HB, Natvig B, Hagen KB, Østerås N, Haugen IK. Smoking and Alcohol Use Are Associated with Structural and Inflammatory Hand Osteoarthritis Features in a Population Based Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/smoking-and-alcohol-use-are-associated-with-structural-and-inflammatory-hand-osteoarthritis-features-in-a-population-based-study/. Accessed November 15, 2015.

Finckh A, Gottenberg J, Hernández MV, Iannone F, Lie E, Canhao H, Pavelka K, Turesson C, Lund Hetland M, Mariette X. The Impact of Tobacco Smoking on the Effectiveness of Abatacept in Rheumatoid Arthritis: Data from a Paneuropean Analysis of RA Registries [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/the-impact-of-tobacco-smoking-on-the-effectiveness-of-abatacept-in-rheumatoid-arthritis-data-from-a-paneuropean-analysis-of-ra-registries/. Accessed November 15, 2015.

Wendling D, Guillot X, Gossec L, Prati C, Saraux A, Dougados M. ASDAS-Based Remission Was Less Frequent Than Basdai-Based Remission, and Both Were Related to CRP and Smoking in Early Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/asdas-based-remission-was-less-frequent-than-basdai-based-remission-and-both-were-related-to-crp-and-smoking-in-early-axial-spondyloarthritis/. Accessed November 15, 2015.

SCHREIBER K, Barnetche T, Combe B, Morel J, Daien CI. Current and Past Smoking Are Associated with Functional Impairement and Increased Disease Activity in Axial Spondyloarthritis: Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/current-and-past-smoking-are-associated-with-functional-impairement-and-increased-disease-activity-in-axial-spondyloarthritis-systematic-review-and-meta-analysis/. Accessed November 15, 2015.

Sparks JA, Nguyen USDT, Chang SC, Zhang Y, Choi H, Karlson EW. Smoking Behavior Changes after Rheumatoid Arthritis Diagnosis and Risk of Mortality during 36 Years of Prospective Follow-up [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/smoking-behavior-changes-after-rheumatoid-arthritis-diagnosis-and-risk-of-mortality-during-36-years-of-prospective-follow-up/. Accessed November 15, 2015.

Katz PP, Chakravarty E, Katz RS, Michaud K. Impact of Smoking on Patient-Reported Disease Status and Symptoms Among Women with Lupus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/impact-of-smoking-on-patient-reported-disease-status-and-symptoms-among-women-with-lupus/. Accessed November 15, 2015.