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A multinational cross-sectional cohort study suggests that smoking cessation in rheumatoid arthritis (RA) patients is associated with lower disease activity measures, improved lipid profiles and lower rates of cardiovascular (CV) events.
Smoking is not only a known risk factor for the development of both cardiovascular disease (CVD) and RA, it has also been repeatedly shown to blunt treatment (biologics and DMARD) responses in RA patients.
RA patients, without prior CVD, from 10 countries (Norway, UK, Netherlands, USA, Sweden, Greece, South Africa, Spain, Canada and Mexico) were studied. The cohort included 3311 RA patients (1012 former, 887 current and 1412 never smokers).
WIth a median follow-up of 3.5 years, 235 experienced a CV event. At enrolment, current smokers were more likely to have moderate or high disease activity compared with former and never smokers (P < 0.001 for both).
Overall, former and never smokers had significantly lower CVD event rates compared with current smokers [hazard ratio 0.70 (95% CI 0.51, 0.95), P = 0.02 and 0.48 (0.34, 0.69), P < 0.001, respectively].
The CVD event rates for former and never smokers were comparable.
Smoking cessation in patients with RA was associated with lower disease activity and improved lipid profiles and was a predictor of reduced rates of CVD events.