Smoking and Axial Spondyloarthritis

Pedro Machado and colleagues investigated the influence of smoking in axial spondyloarthritis. Smoking was associated with earlier onset of inflammatory back pain, higher disease activity as measured in the Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP) and the BASDAI, worse functional status (BASFI), more structural damage as shown in MRI or X-ray, and apoorer health-related quality of life. The authors see important implications in the education of patients with axial spondyloarthritis and “the need to consider smoking as one of the potential prognostic factors axial spondyloarthritis”.


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Smokers in Early Axial Spondyloarthritis Have An Earlier Disease Onset, More Inflammation and Damage: Results From the DEvenir Des Spondyloarthropathies Indifferenciées Récentes Cohort.
Pedro Machado1, Ho Y. Chung2, Desirée van der Heijde3, Maria-Antonietta D’Agostino4 and Máxime Dougados5.
1Leiden University Medical Center, Leiden, Netherlands&Coimbra University Hospital, Coimbra, Portugal, 2Leiden University Medical Center, Leiden, Netherlands & Queen Mary Hospital, Hong Kong, China, 3Leiden University Medical Center, Leiden, Netherlands, 4Versailles-Saint Quentin en Yvelines University-APHP, Ambroise-Pare´ Hospital, Boulogne-Billancourt, France, 5Paris-Descartes University, Cochin Hospital, Paris, France
Conclusion: In patients with early axial SpA, smoking was independently associated with earlier onset of IBP, higher disease activity, poorer functional status, increased axial inflammation on MRI and axial structural damage on MRI and radiographs, and worse HRQoL. These observations may have important implications in the education of patients with axial SpA and highlight the need to consider smoking as one of the potential prognostic factors in axial SpA as well as one of the environmental factors potentially involved in the pathogenesis of the disease.