Cigarette Smoking and ANCA-Associated Vasculitis Save

JAMA Internal Medicine has reported that cigarette smoking associated with an increased odds of having antineutrophil cytoplasmic antibody–associated vasculitis (AAV) (especially MPO positive AAV) and is thereby a modifiable risk factor for AAV.

In a case-control study, 473 AAV patients were compared with 1419 matched controls from Partners HealthCare Biobank who were asled tp complete a smoking questionnaire. 

The patients had a mean age of 59 years; 59% were women, and mostly white (84%). AAV patients were more likely to be former (OR, 1.6; 95% CI, 1.3-2.0) or current smokers (OR, 2.7; 95% CI, 1.8-4.1).

The found a dose-response relationship according to pack-years of exposure (P < .001). These associations were especially strong among participants with MPO-ANCA–positive disease (former smokers: OR, 1.7; 95% CI, 1.3-2.3; current smokers: OR, 3.5; 95% CI, 2.1-6.1) but not in participants with PR3-ANCA–positive AAV (former smokers: OR, 1.3; 95% CI, 0.9-2.0; current smokers: OR, 1.7; 95% CI, 0.8-3.5). 

Cigarette smoking was associated with AAV, especially MPO-ANCA–positive AAV. Further studies are needed to investigate a potential pathogenic mechanism.