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Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

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Smoking tied to higher disease activity in RA

20 Apr 2019
In 2015, a study implied that preventive measures such as smoking cessation were pointless in preventing cancer.

An association exists between smoking and higher levels of disease activity in rheumatoid arthritis (RA), suggests a new study.

Compared with nonsmoking, smoking correlated with a 0.64-unit increase in the patient global score (p=0.01) and with 2.58 more swollen joints (p<0.001). Smoking was also associated with a higher clinical disease activity score (2.11), but the difference was statistically nonsignificant (p=0.22).

On the other hand, there was no association between smoking and physician global score or C-reactive protein levels, but an inverse interaction was found between smoking and tender joint count (p=0.05). Furthermore, there was a null relationship for all outcomes in analyses using conventional methods.

“Causal methods may be useful for investigations of additional exposures on longitudinal outcome measures in rheumatologic disease,” the authors said.

This study examined the link between smoking and RA outcomes using statistical methods that accounted for time-varying confounding and loss to follow-up. Electronic health record data collected at a public hospital between 2013 and 2017 were used to identify 282 individuals with an RA diagnosis.

The authors evaluated current smoking status and disease activity at each visit, including sex, race/ethnicity, age, obesity and medication use as covariates. They calculated the causal effect of smoking on disease activity measures at 27 months using longitudinal targeted maximum likelihood estimation and compared results to conventional longitudinal methods.

“Prior studies around the relationship between smoking and RA disease activity have reported inconsistent findings, which may be ascribed to heterogeneous study designs or biases in statistical analyses,” the authors noted.

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Most Read Articles
5 days ago

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

3 days ago
Susceptibility‐guided therapy is as effective as empiric modified bismuth quadruple therapy for the first-line treatment of Helicobacter pylori infection, with both yielding excellent eradication rates, as shown in a recent trial.
5 days ago
It appears that long-term consumption of fish and omega-3 fatty acid does not influence the risk of incident hypertension in middle-aged and older men, suggests a US study.
3 days ago
The risk factors and outcomes associated with an increased risk of permanent pacing include atrial fibrillation (AF) ablation, multivalve surgery and New York Heart Association (NYHA) functional class III/IV, a recent study has found.