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.
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