medwireNews: Alcohol consumption may be a modifiable risk factor for spinal structural damage among patients with axial spondyloarthritis (axSpA), researchers report.
Seung-Ki Kwok (The Catholic University of Korea, Seoul) and colleagues used the Catholic Axial Spondyloarthritis Cohort to investigate disease progression among 278 axSpA patients who were included in the database between 2015 and 2017 and divided into alcohol consumers and non-consumers based on questionnaire results.
As reported in Arthritis Research & Therapy, the 206 patients who consumed alcohol experienced a significantly greater worsening in mSASSS score from baseline to the 2-year follow-up than the 72 non-consumers, with average increases of 2.7 versus 1.5 points. Mean baseline scores were comparable in the two groups, at 11.7 and 11.2 points, respectively.
In accordance with these results, alcohol consumers had significantly greater mean increases in syndesmophyte count than non-consumers over the study period, at 0.9 versus 0.4.
Patients who consumed alcohol were also significantly more likely than non-consumers to experience significant progression of spinal structural damage, defined as either an increase in mSASSS of at least 2 points over 2 years (60.7 vs 29.2%) or the occurrence of new syndesmophytes or progression of pre-existing syndesmophytes (51.5 vs 26.4%).
On multivariable analysis adjusting for factors including age, sex, disease severity, and smoking status, alcohol consumers had a 4.4-fold increased risk for experiencing significant mSASSS progression than non-consumers.
Kwok and colleagues did not identify a dose-dependent relationship between alcohol consumption and axSpA progression, but they caution that the small number of patients, especially those classified as “heavy drinkers” (>14 units/week; n=57) meant that “stratifying alcohol consumption into multiple levels was impossible.”
The team also notes that the duration of follow-up was “relatively short,” and that “[f]urther studies using a larger sample size and longer follow-up duration are needed.”
Nonetheless, the study demonstrated “the association between alcohol consumption and spinal structural progression in axSpA patients for the first time,” emphasize the researchers.
“Previously, smoking was the sole known modifiable predictor of spinal structural damage,” they add.
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