Does Smoking Affect ANCA-Associated Vasculitis Disease Activity?

Smoking may lead to a more advanced disease progression and worse prognosis for patients with ANCA-associated vasculitis (AAV), according to the findings of a recent study published in the Polish Archives of Internal Medicine.

“Smoking is associated with increased disease activity, renal replacement therapy and immunosuppressive treatment, resulting in a poorer survival prognosis in AAV patients,” the Polish study read.

Upon analyzing 223 AAV patients (46% women) over a span of 32 years between October 1988 and August 2020, the mean age at diagnosis was 53.3 years. The patients from Medical University of Gdansk in Poland were classified as never smokers (n=116) and ever smokers (n=107). The ever smoker group included current smokers (n=39) and past smokers (n=68) A significantly greater proportion of ever-smokers were men relative to nonsmokers (71% vs. 39%).

The researchers found that the time between symptom onset and AAV diagnosis was significantly shorter for patients who smoked versus patients who never smoked (mean of 4 months vs 6 months)

While organ involvement and symptoms were similar between both groups, patients who smoked required kidney replacement therapy more often than those who never smoked (31% vs 14%)

The levels of C-reactive protein were significantly higher in the smoking group than the nonsmoking group. Also, the mortality rate was higher in the smoking group than in the nonsmoking group (23% vs 9%)

“Future multicenter studies are required to further characterize the clinical, biological, and prognostic impact of smoking on AAV,” the authors concluded.

Reference:
Patel A, Masiak A, Joshi S, Zietkiewicz M, Zdrojewski Z. Influence of smoking on disease activity and prognosis of ANCA-associated vasculitis: a retrospective cohort study. Polish Archives of Internal Medicine. Published online: April 14, 2023. DOI: 10.20452/pamw.16478