Smoking habit and its possible relationship with clinical and humoral activity in patients with rheumatoid arthritis
Keywords:
Rheumatoid arthritis, smoking habitAbstract
Introduction: Smoking patients not only have a higher risk of developing the disease but also do so in a different manner, with earlier onset, worse response to treatment, greater joint destruction, and higher levels of autoantibodies compared to non-smokers.
Objectives: To identify the relationship between smoking and rheumatoid arthritis, as well as clinical activity and the presence of Anti-CCP antibodies.
Methods: A descriptive cross-sectional study included 100 patients with active rheumatoid arthritis divided into two groups: smokers and non-smokers, treated at the Reference Center for Rheumatic Diseases from January 2023 to January 2024. Disease activity was assessed using DAS 28, and Anti-CCP levels were determined.
Results: Females represented 80.0 %, with a mean age of 49 years. 21.0 % of patients had severe clinical activity, 61.0 % moderate, and 18.0% mild. The highest percentage of patients with severe activity were smokers (36.0 %), while mild activity predominated in non-smokers (28.0 %). 78.0 % tested positive for Anti-CCP antibodies, with higher titers corresponding to smokers.
Conclusions: Female patients with a mean age of 49 years predominated. Smokers showed higher rates of moderate and severe clinical activity. An association was found between peptide levels and smoking. The global mean erythrocyte sedimentation rate was significantly higher in smokers compared to non-smokers.
Downloads
References
1-IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines. Lyon (FR): International Agency for Research on Cancer; 2007. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 89.) [Internet]. [citado 24 Feb 2025]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK326497/
2-Abbas A, Lichtman A, Jordan S. Enfermedades causadas por respuestas inmunitarias: Hipersensibilidad y autoinmunidad En: Inmunología celular y molecular. 12a ed. 2012:419- 40.
3-Venetsanopoulou AI, Alamanos Y, Voulgari PV, Drosos AA. Epidemiology of rheumatoid arthritis: genetic and environmental influences. Expert Rev Clin Immunol [Internet]. 2022 [citado 24 Feb 2025];18(9):923-31. Disponible en: http://dx.doi.org/10.1080/1744666X.2022.2106970
4-Rossides M. Rheumatoid arthritis and COPD: Thinking beyond smoking. Chest [Internet]. 2024 [citado 24 Feb 2025];165(6):1278-9. Disponible en: http://dx.doi.org/10.1016/j.chest.2024.03.005
5-Roodenrijs NMT, van der Goes MC, Welsing PMJ, Tekstra J, Lafeber FPJG, Jacobs JWG, et al. Difficult-to-treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology (Oxford) [Internet]. 2021 [citado 24 Feb 2025];60(8):3778-88. Disponible en: http://dx.doi.org/10.1093/rheumatology/keaa860
6-Zhao SS, Holmes MV, Zheng J, Sanderson E, Carter AR. The impact of education inequality on rheumatoid arthritis risk is mediated by smoking and body mass index: Mendelian randomization study. Rheumatology (Oxford) [Internet]. 2022 [citado 24 Feb 2025];61(5):2167-75. Disponible en: http://dx.doi.org/10.1093/rheumatology/keab654
7-Koller-Smith L, Mehdi AM, March L, Tooth L, Mishra GD, Thomas R. Rheumatoid arthritis is a preventable disease: 11 ways to reduce your patients’ risk. Intern Med J [Internet]. 2022 [citado 24 Feb 2025];52(5):711-6. Disponible en: http://dx.doi.org/10.1111/imj.15537
8-Wang M, Pan H, Zhai Y, Li H, Huang L, Xie Z, et al. Bidirectional association between rheumatoid arthritis and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Front Immunol [Internet]. 2024 [citado 24 Feb 2025];15:1494003. Disponible en: http://dx.doi.org/10.3389/fimmu.2024.1494003
9-Gwinnutt JM, Wieczorek M, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, et al. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis [Internet]. 2022 [citado 24 Feb 2025];82(1):48-56. Disponible en: http://dx.doi.org/10.1136/annrheumdis-2021-222020
10-Conran C, Kolfenbach J, Kuhn K, Striebich C, Moreland L. A review of difficult-to-treat rheumatoid arthritis: Definition, clinical presentation, and management. Curr Rheumatol Rep [Internet]. 2023 [citado 24 Feb 2025];25(12):285-94. Disponible en: http://dx.doi.org/10.1007/s11926-023-01117-6
11-Sullivan DI, Ascherman DP. Rheumatoid arthritis-associated interstitial lung disease (RA-ILD): Update on prevalence, risk factors, pathogenesis, and therapy. Curr Rheumatol Rep [Internet]. 2024 [citado 24 Feb 2025];26(12):431-49. Disponible en: http://dx.doi.org/10.1007/s11926-024-01155-8
12-Wang H-F, Wang Y-Y, Li Z-Y, He P-J, Liu S, Li Q-S. The prevalence and risk factors of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis. Ann Med [Internet]. 2024 [citado 24 Feb 2025];56(1):2332406. Disponible en: http://dx.doi.org/10.1080/07853890.2024.2332406
13-Wang J, Zhang B, Peng L, Wang J, Xu K, Xu P. The causal association between alcohol, smoking, coffee consumption, and the risk of arthritis: A meta-analysis of Mendelian randomization studies. Nutrients [Internet]. 2023 [citado 24 Feb 2025];15(23):5009. Disponible en: https://www.mdpi.com/2072-6643/15/23/5009
14-Maisha JA, El-Gabalawy HS, O’Neil LJ. Modifiable risk factors linked to the development of rheumatoid arthritis: evidence, immunological mechanisms and prevention. Front Immunol [Internet]. 2023 [citado 24 Feb 2025];14:1221125. Disponible en: http://dx.doi.org/10.3389/fimmu.2023.1221125
15-David P, Di Matteo A, Hen O, Dass S, Marzo-Ortega H, Wakefield RJ, et al. Poly‐refractory rheumatoid arthritis: An uncommon subset of difficult to treat disease with distinct inflammatory and noninflammatory phenotypes. Arthritis Rheumatol [Internet]. 2024 [citado 24 Feb 2025];76(4):510-21. Disponible en: http://dx.doi.org/10.1002/art.42767
16-Nayebirad S, Javinani A, Javadi M, Yousefi-Koma H, Farahmand K, Atef Yekta R, et al. The effect of smoking on response to methotrexate in rheumatoid arthritis patients: A systematic review and meta-analysis. Mod Rheumatol [Internet]. 2023 [citado 24 Feb 2025];34(1):68-78. Disponible en: http://dx.doi.org/10.1093/mr/road013
17-Safy-Khan M, de Hair MJH, Welsing PMJ, van Laar JM, Jacobs JWG, Society for Rheumatology Research Utrecht (SRU). Current smoking negatively affects the response to methotrexate in rheumatoid arthritis in a dose-responsive way, independently of concomitant prednisone use. J Rheumatol [Internet]. 2021 [citado 24 Feb 2025];48(10):1504-7. Disponible en: http://dx.doi.org/10.3899/jrheum.200213
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Dianayis Hortelas Sánchez, Dinorah Marisabel Prada Hernández, Yusimí Reyes Pineda, Jorge Alexis Gómez Morejón, Silvia Maria Pozo Abreu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Warning of rights of author
The authors that publish in this journal agree with the following terms:
The authors conserve the rights of author and concede to the journal the right of the first publication, fulfilling with the license Creative Commons Attribution License that allows to others share the work with recognition of the authorship of their articles, and the initial publication in this journal.
The authors can establish separately additional agreements for the no exclusive distribution of the version of the work published in the journal (for example, situate it in an institutional repository, in a personal blog or publish it partial or totally in a book), with a recognition of their initial publication in this journal.
To be able to send the manuscript or part of him passed three months of published, for his evaluation to other publishers, identifying it or not with the same title; whenever allusion is made to our journale and know it the new publisher.
The publishing committee of the Cuban Journal of Rheumatology authorizes to other publishers, to reproduce the articles published in our magazine, whenever it indicate the origin of the same.
The authors should send a document in Office Word application format through the electronic address of the magazine with a similar format to that we include next:
---------------------------------------------------------------------------------------------------------------------
Statement of authorship and cede of articles for the publication of the scientific work in the Cuban Journal of Rheumatology
Date:
Those who subscribe certify that are the authors of the work:
Of this form communicate the originality of our article clearing that the concepts and knowledges of other authors that have included in the text of the article, have been quoted properly in the bibliography.
We do proof besides that the article in question is original and has not been published, total neither partially, in another journal.
To be approved for his publication in the Cuban Journal of Rheumatology, do secession of the rights of publication to the same one through the method that realizes it usually.
In front of any catchword that exist by the article that send to evaluate, relieve of of the responsibility to the Cuban Journal of Rheumatology holding us responsible with all the difficulties that can berelated by any situation.
We include to continuation the name and the signature of all authors and collaborators of this article.
Name: Signature:
