Quitting smoking confers benefits for disease activity, CVD risk in rheumatoid arthritis

Rheumatoid arthritis (RA) patients who quit smoking may benefit from improved disease activity, better lipid profiles and reduced frequency of cardiovascular disease (CVD) events, as suggested in a recent study.

The study included 3,311 RA patients, among whom 1,012 were former smokers, 887 current smokers and 1,412 never smokers. A total of 235 patients overall experienced at least one CVD event during a median follow-up of 3.54 years.

Across the smoking status groups, significant differences were observed in age (ranging from 53.6 years among current smokers to 58.8 years in the former smokers) and female predominance (ranging from 86.5 percent in those who had never smoked to 62.8 percent among those who were former smokers).

Moreover, current smokers had lower body mass index, longer disease durations, and used fewer lipid-lowering and antihypertensive medications compared with former and never smokers. There were also significant differences seen in the use of various antirheumatic drugs.

Current smokers were more likely to have moderate or high disease activity at baseline relative to former and never smokers (p-both<0.001). A gradient of worsening CVD risk factor profiles (lipoproteins and blood pressure) emerged across categories of smoking status—from never to former to current smokers.

Finally, compared with current smokers, former and never smokers had lower CVD event rates (hazard ratio [HR], 0.70, 95 percent confidence interval [CI], 0.51–0.95; p=0.02 and HR, 0.48, 95 percent CI, 0.34–0.69; p<0.001, respectively). The rates for former and never smokers were similar.

The present data highlight the importance of recommending and encouraging smoking cessation in patients with RA, according to the researchers.