The bad news? Smoking increases the chances of early death in people with RA (rheumatoid arthritis) patients. The upside? Quit smoking and the risk goes down significantly. This is according to work from the University of Manchester in England.
RA Patients: Smoking Increases Risk of Early Death
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“This research provides important evidence that the risk of early death starts to decline in patients who stop smoking, and continues year on year, ” said researcher Deborah Symmons, M.D., in the April 4, 2016 news release. She is a professor of rheumatology and musculoskeletal epidemiology at the University of Manchester.
As indicated in the news release, “The investigators found that the patients who smoked were nearly twice as likely to die prematurely as those who never smoked. The risk among former smokers was similar to that of those who never smoked, and fell for each additional year they no longer smoked.”
“We hope that this research can be used by public health professionals and rheumatologists to help more people quit smoking and reduce premature deaths, particularly for newly diagnosed patients with rheumatoid arthritis, ” Dr. Symmons added.
Dr. Symmons told OTW, “We were aware of a higher prevalence of smoking among patients with rheumatoid arthritis, and also that many patients continue to smoke despite being advised not to. So we were looking for evidence to provide to patients of the ongoing harm of smoking after the onset of rheumatoid arthritis.”
“We were pleasantly surprised to find that the harmful effects of smoking with regards to lung disease were confined to heavy smokers and also that there was a demonstrable benefit to stopping smoking. For some outcomes, former smokers did worse than current smokers. That is probably because they had only stopped smoking after a serious smoking-related event like a heart attack or admission to hospital with a chest infection.”
“I suspect that orthopedic surgeons are already aware that smokers have a worse outcome with regards to post-operative chest infections. It is probably worth emphasizing that this applies to patients with RA, as well as osteoarthritis.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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