Smoking as a risk factor for the radiological severity of rheumatoid arthritis: a study on six cohorts

Abstract

This multi-cohort study indicated that the effect of smoking on joint damage is mediated via ACPA and that smoking is not an independent risk factor for radiological progression in RA.

Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis: a cross-sectional analysis of US veterans

“…Similar to our results, several studies have associated current smoking with increased measures of disease activity [9,21,23], whereas others did not observe differences in levels of disease activity but did report increased disease damage [8,33,34] among current smokers. Our results are unique in the inclusion of current and former smokers, thus enabling separation of the effect of current smoking from ever smoking.…”

Use of complementary and alternative medicines is associated with delay to initiation of disease‐modifying anti‐rheumatic drug therapy in early inflammatory arthritis

“…In addition, we found smoking and higher disease activity to be associated with CAM use. Smoking is known to be associated with seropositive RA and together with higher disease activity, is likely a marker for more severe disease . It is precisely these patients who would benefit from early DMARD initiation to prevent radiographic progression and disability, underlining the public health importance of CAM use in this population.…”

Reply

“…As a group, we (the Ultrasound School of North American Rheumatologists [USSONAR]) have participated in the training of over 130 rheumatology fellows in the use of MSUS. Fellows participating in the USSONAR program demonstrated proficiency in musculoskeletal anatomy on both practical and written examinations (2,3). We are therefore confident that every fellow who completes MSUS training would be able to identify Lister tubercle of the radius, the structure that only 29% of the participants correctly identified in the study by Navarro-Zarza et al…”

“…In contrast, there is no indication that the prevalence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) may be higher in smokers than in the general population. Recently, 2 articles have suggested smoking as a potential risk factor for the radiologic severity of RA (3,4). However, after adjustment, it has been shown that the effect of smoking on joint damage was mediated via ACPA and that smoking was not an independent risk factor for radiologic progression in RA.…”