Sustained Smoking Cessation May Delay, Prevent Seropositive RA
While risk increases with pack-years smoked, it decreases with longer duration of smoking cessation
WEDNESDAY, Feb. 27, 2019 (Pharmacist's Briefing) -- While smoking is a strong risk factor for seropositive rheumatoid arthritis (RA), sustained smoking cessation could delay or even prevent disease development, according to a study published online Feb. 21 in Arthritis Care & Research.
Xinyi Liu, from Brigham and Women's Hospital in Boston, and colleagues assessed smoking cessation and RA risk among participants in the Nurses' Health Study (NHS; 1976 to 2014) and the NHSII (1989 to 2015). Biennial questionnaires were used to ascertain smoking exposure, while self-reported RA was confirmed by medical record review.
The researchers found that among 230,732 women, there were 1,528 incident RA cases (63.4 percent seropositive). Current smoking increased risk for all RA (multivariable hazard ratio [HR], 1.47; 95 percent confidence interval, 1.27 to 1.72) and seropositive RA (HR, 1.67; 95 percent confidence interval, 1.38 to 2.01) but not seronegative RA (HR, 1.2; 95 percent confidence interval, 0.93 to 1.55) compared with never smoking. The risk for all RA increased with increasing smoking pack-years and seropositive RA. A decreased trend in risk was seen with increasing duration of smoking cessation for all RA and seropositive RA. Although those who quit ≥30 years ago had a hazard ratio of 0.63 for seropositive RA compared with recent quitters (less than five years), there was still a modestly elevated RA risk detectable 30 years after quitting smoking (all RA: HR, 1.25; seropositive RA: HR, 1.3 [both compared with never smoking]).
"Our study is one of the first to show that a behavior change of prolonged smoking cessation may actually delay or even prevent the onset of seropositive RA, suggesting lifestyle changes may modify risk for development of a systemic rheumatic disease," a coauthor said in a statement.