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A report from The National Databank for Rheumatic Disease addressed the impact of alcohol on disease activity and mortality in rheumatoid arthritis (RA) and found that alcohol use was not associated with changes in disease activity or mortality, after addressing confounders.
It has been reported that alcohol use in RA is associated with lower disease activity (measured by the PAS) and better quality of life measures. But is this directly attributable to an antiinflammatory effect or might the association might be explained by reverse causality.
The NDB has 16,762 RA participants who were assessed for alcohol use, disease activity, and other outcomes.
They found that there was greater alcohol discontinuation and less alcohol initiation with greater disease activity, older age, female sex, nonwhite race, obesity, greater comorbidity, low quality of life, low educational level, low income, and work disability.
While alcohol users did have lower PAS‐II scores and a lower mortality (odds ratio 0.87), these associations were not seen in after adjusting for confounders.
Higher disease activity, disability, comorbidity, and poor quality of life contribute to overall reductions in alcohol use.
Active use alcohol use should not be promoted with the aim of reducing disease activity or mortality.