Smoking Worsens Disease Severity in Axial Spondyloarthritis

Individuals who have ever smoked and who have axial spondyloarthritis are more likely to have worse disease activity and quality of life than people who have never smoked, according to Sizheng Zhao, MBBS, and colleagues. Using data from British Society for Rheumatology Biologics Register for Ankylosing Spondylitis (BSRBR-AS), researchers examined whether smoking status, amount smoked, and smoking cessation had an impact on 5 disease indices. ________________________________________________________________________________________________________________________________________________________________________ RELATED CONTENT Smoking Cessation at Any Age Reduces Risk of Death After 70 Could Cigarette Smoking During Pregnancy Lead to Schizophrenia? ________________________________________________________________________________________________________________________________________________________________________ Of the 932 patients (71% men) in the cross-sectional analysis, there were 19% who were current smokers, 37% who were ex-smokers, and 44% who never smoked. Approximately 37% of smokers reported smoking more than 10 cigarettes each day, and they were classified as heavy smokers. None of the patients in the study had taken biologics. After adjustment for age, sex, BMI, and HLA-B27 status, the analysis showed that people who had ever smoked had worse disease across all 5 disease markers. In addition, disease activity was better among individuals who had quit smoking than among those who continued to smoke. When researchers stratified the analysis of heavy and light smoking by sex, they found that spinal pain and visual analogue scores for women were higher. However, this difference was not seen on the other measures. In a separate analysis, Dr. Zhao and colleagues also examined smoking exposure and disease activity in 238 patients who smoked. Results from this analysis indicated that higher scores on disease activity and functional impairment measures were seen in patients who had smoked for more than 20 pack-years. Those who were the heaviest smokers were more than 4 times as likely to be in a higher disease activity category, compared with those were classified as light smokers. “Particular effort should be made to restrict smoking exposure early, before accruing a significant number of pack-years,” the study’s authors wrote. —Lauren LeBano References 1. Zhao S, Jones GT, Barnish MS, et al. Smoking exposure is associated with increased disease severity in axial spondyloarthritis: Results from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis (BSRBR-AS). BSR 2017. Abstract 99. 2. Zhao S. Challoner B, Khattak M, Goodson NJ. Cigarette smoking and disease activity in axial spondylitis: evidence of an exposure-response relationship. BSR 2017. Abstract 105.