Background It is not known if smoking cessation after onset of rheumatoid arthritis (RA) has effect on disease activity.
Objectives To assess the effect of smoking cessation on disease activity in patients with RA in a 15-year follow up.
Methods Between 1992 and 2005, 2800 adult patients were included in the BARFOT early RA study in Sweden. Disease Activity Score 28 joints (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), anti-CCP, general health and pain visual analog scales (VAS), EULAR response and remission criteria and treatment were registered at inclusion and at follow-up, 3 and 6 months, 1 year, 2, 5, 8 and 15 years. In 2010, a self-completion postal questionnaire was sent to 2102 patients enquiring about life style factors, inclusive demographics, such as socioeconomic class (SEI), and smoking habits including smoking cessation.
Results A total of 1460 adult RA patients with disease duration ≤24 months were included in this study. A total of 17% smoked in 2010. A total of 127 patients stopped smoking after inclusion in the study. Smoking cessation after inclusion in the study was negatively associated with EULAR outcome at 8 years (N=560, OR 0.44, 95% CI 0.22-0.86, p=0.02), adjusted for age, disease duration, sex, socioeconomic class, smoking status, RF and DAS28. Higher DAS28 and male sex predicted better EULAR response at 8 years and SEI class “Other” and RF predicted poor EULAR response.
Conclusions A total of 17% of the RA patients smoked in 2010 in this large Swedish RA cohort. Smoking cessation after RA onset did not change the poor prognosis of smokers in RA. This could be due to a selection effect. Our data needs to be confirmed in larger studies
Disclosure of Interest M. Söderlin Consultant for: Pfizer <$5000, Speakers Bureau: MSD<$2000, Abbott<$5000, Pfizer<$5000, M. Andersson: None Declared, S. Bergman: None Declared
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