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The impact of smoking on disease activity, disability, and radiographic damage in rheumatoid arthritis: is cigarette protective?

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A Correspondence to this article was published on 05 December 2017

Abstract

The ojective of this study is to assess the effect of tobacco smoking on disease activity, functional ability, and joint damage in a cohort of patients with early onset rheumatoid arthritis (EORA). 129 EORA patients attending the Rheumatology Unit of the School of Medicine of the “Universidad Nacional de Colombia” and the “Clínica de Artritis y Rehabilitación” in Bogota, Colombia, were enrolled in a prospective observational cohort study with 3-year follow-up. Clinical, biological, immunogenetics, and radiographic data were analyzed. Active disease was defined as DAS28 > 2.6. Smoking status was assessed by self-report as “never smokers” and “ever smokers”. Patient groups with different smoking status were compared for RA measures. Status as “never smokers” and “ever smokers” was reported by 81.3 and 18.7%. Ever smokers had less risk of disability (HAQ-DI ≥ 0.5) at 36 month (Ever smokers vs. Never smokers OR for HAQ ≥ 0.5 0.25, 95% CI 0.06–0.97, p = 0.04). When former smokers were excluded in analysis, we found that current smoking was also associated with less disability and less risk of active disease. The percentage of erosive disease, radiographic progression, and SvdH score were similar in all smoking categories. In Colombian patients with EORA, smoking was associated with less disease activity and disability. Radiographic joint damage progressed at an equivalent rate in smokers and non-smokers. These data suggest a more benign, or at least not deleterious clinical course in smokers with RA.

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Authors and Affiliations

  1. Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Avenida de las Américas No 98-56, Pereira, 660004, Colombia

    Mario Andrés Quintana-Duque

  2. Rheumatology Unit, Faculty of Medicine, National University of Colombia, Kra 45 No 26-85, Bogotá, Colombia

    Federico Rondon-Herrera & Antonio Iglesias-Gamarra

  3. IPS Clinica San Rafael, Kra 25 No 74A-87, Pereira, Colombia

    Adriana Varela-Nariño

  4. Radiology Unit, Faculty of Medicine, National University of Colombia, Kra 45 No 26-85, Bogotá, Colombia

    Enrique Calvo-Paramo

  5. Pathology Unit, Genetic Institute, Faculty of Medicine, National University of Colombia, Kra 45 No 26-85, Bogotá, Colombia

    Juan Jose Yunis

Authors
  1. Mario Andrés Quintana-Duque
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  2. Federico Rondon-Herrera
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  3. Enrique Calvo-Paramo
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  4. Juan Jose Yunis
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  5. Adriana Varela-Nariño
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  6. Antonio Iglesias-Gamarra
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Correspondence to Mario Andrés Quintana-Duque.

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Conflict of interest

Mario Andrés Quintana Duque, Federico Rondon Herrera, Enrique Calvo Paramo, Juan Jose Yunis, Adriana Varela Nariño and Antonio Iglesias-Gamarra, declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Quintana-Duque, M.A., Rondon-Herrera, F., Calvo-Paramo, E. et al. The impact of smoking on disease activity, disability, and radiographic damage in rheumatoid arthritis: is cigarette protective?. Rheumatol Int 37, 2065–2070 (2017). https://doi.org/10.1007/s00296-017-3845-8

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  • DOI: https://doi.org/10.1007/s00296-017-3845-8

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