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Objective. While cigarette smoking is the best-studied environmental factor contributing to rheumatoid arthritis (RA), no study to date has examined the influence of smoking cessation on disease activity. We examined this relationship in an observational cohort of patients with RA in the United States.
Methods. Patients enrolled in the Consortium of Rheumatology Researchers of North America registry (CORRONA) were stratified into never, former, and current smokers at enrollment. Current smokers were further stratified into continued and ceased smoking groups during their followup in the registry. The primary outcome was change in Clinical Disease Activity Index (CDAI) at last visit in a multivariate, random-effects regression model accounting for multiple timepoints.
Results. At last visit, there was no significant change in CDAI between ceased smokers and continued smokers (coefficient −0.00091, SE 0.0033, p = 0.7834). The study did confirm prior cross-sectional studies that current smokers have worse disease activity than former or never smokers.
Conclusion. In the short term, smoking cessation did not appear to influence change in disease activity over time.
Dr. Greenberg is supported by research grants from the US National Institutes of Health (NIH; K23AR054412), the Arthritis Foundation, and Bristol Myers Squibb and has served on advisory boards for BMS, Centocor, Genentech, Roche, and UCB. Research support was provided to Dr. Kremer by Amgen, Abbott, Centocor, BMS, Roche, and Genentech, and honoraria from Abbott, Centocor, BMS, Roche, and Genentech. Dr. Hochberg served as a consultant for Amgen, Bristol Meyers Squibb, Roche, and UCB. CORRONA has received support from Abbott, Amgen, BMS, Centocor, Genentech, Lilly, and Roche.
- Accepted for publication December 14, 2011.