Smoking Leads to Worse RA Flare and Remission Patterns

Flare and remission rates were examined for 650 RA patients
Flare and remission rates were examined for 650 RA patients

WASHINGTON, DC—Tobacco smoking adversely impacts rheumatoid arthritis (RA) flare and remission rates, according to findings from a long-term retrospective, population-based cohort study, presented at the 2016 ACR/ARHP Annual Meeting.

“In this long-term follow-up study, current smokers have higher rates of flares compared to non-smokers,” reported lead study author Shafay Raheel, MD, Rheumatology, Mayo Clinic, in Rochester, MN. “Concordantly, remission rates were lower in smokers compared to the non-smokers.”

Patients should be advised of the association, Dr. Raheel said.

The research team examined flare and remission status for 650 RA patients with a mean follow-up of 10.3 years. The average patient age was 55.8 years and 69% of the patients were women.

“Patients were flaring in 2,887 (17%) visits and were in remission in 1,747 (10%) visits,” Dr. Raheel reported. “Current smokers had higher flare rates than non-smokers (P=0.047) and former smokers were not different from non-smokers (P=0.87).”

Smoking status and RA flare rates did not correlate during the “first few years of RA,” but smokers subsequently developed a trend toward higher flare rates than non-smokers (P=0.072).

Flares were similar for non-smokers and former smokers (P=0.16, n.s.).

"The overall rate of [RA] remission by baseline smoking status was significantly lower in current smokers than non-smokers (P=0.034),” Dr. Raheel said. “There was no difference in remission rates for former smokers compared to non-smokers (P=0.24, n.s.), and no indication that remission rates differed over the disease course for current smokers (interaction P=0.42, n.s.) or former smokers (interaction P=0.93, n.s.) compared to non-smokers.”