Background RA is a chronic systemic autoimmune inflammatory disease that affect all ethnic groups throughout the world, the main characteristic symptoms is persistent synovitis of diarthroidal joints often symmetrical resulting in pain, stiffness, and limitation of movement. Smoking is the most established environmental risk factor for development, severity, and extra-articular manifestation of RA.
Objectives To assess the association between smoking and RA disease activity (DAS 28) and extra-articular manifestation
Methods A cross sectional study was conducted on 244 patients with RA meeting the American College of Rheumatology Criteria for the classification of RA, Patients data were obtained via face - to- face interview performed by rheumatologist. RA disease-related data, such as disease duration, rheumatoid factor positivity, drug use (all anti-rheumatic drugs, glucocorticoid use and NSAID’s), history of smoking which is classified into current smoker, former Smoker ( patient discontinue smoking for at least three months ), and never smoker, also number of cigarette per day were also recorded. Extra-articular manifestation of RA were assessed in all patient by thorough physical examination, and the patient send for appropriate investigation to confirm the diagnosis. Disease activity was measured using the Disease Activity Score based on evaluation of 28 joints (DAS28)
Results Among 244 patients with RA 76.2% were women and 23.8% were men, the females were significantly predominate the study samples (P<0.001). The mean (SD) age are 46.9 ± 11.4, the age varies with smoking history (P=0.043). It is significant to find that two third of patients (69.3%) not have smoking history (P<0.001) because majority of patients were female. Smoking is significantly increase rheumatoid factor positivity (P=0.013), also associated with higher disease activity (DAS 28) (P<0.001). Smoking is significantly associated with rheumatoid nodules (P<0.001), secondary Sjögren syndrome (P<0.001), and eye involvement (P=0.002), while there is no significant association with other extra-articular manifestations
Conclusions There is significant association between smoking and RA disease activity (DAS 28) and extra-articular manifestations
Disclosure of Interest None Declared