Seropositive and seronegative RA show very different associations with smoking

  • Liu X & al.
  • Arthritis Care Res (Hoboken)
  • 21 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • In this analysis from the Nurses’ Health Studies, women who quit smoking ≥30 years ago had lower risk for seropositive rheumatoid arthritis (RA) than women who quit 0 to
  • No such association seen with smoking and seronegative RA.

Why this matters

  • These 2 large, prospective cohorts cover 38 years and more than 6 million person-years.
  • Seronegative and seropositive RA may have different etiologies, risk factors.

Key results

  • Vs never smoking, current smoking (adjusted HRs; 95% CIs):
    • Increased risk for any RA: 1.47 (1.27-1.72).
    • Increased risk for seropositive RA: 1.67 (1.38-2.01).
    • Did not affect risk for seronegative RA: 1.20 (0.93-1.55).
  • Among ever smokers, vs quitting
  • Even with 3 decades of nonsmoking, however, these women still had slightly elevated RA risk vs never smokers (HRs, 95% CIs):
    • Any RA: 1.25 (1.02-1.53); 
    • Seropositive RA: 1.30 (1.01-1.68).
  • Seronegative RA showed no associations with smoking.

Study design

  • Data from the 1976-2014 (n=117,182) and 1989-2015 (n=113,550) cohorts of the Nurses’ Health Studies.
  • Funding: NIH.

Limitations

  • These cohorts are mostly well-educated white women who are nurses, so generalization is unclear.