Smoking Leads to Worse RA Flare and Remission Patterns

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.”