Session Information
Session Type: Poster Session A
Session Time: 10:30AM-12:30PM
Background/Purpose: Rheumatoid arthritis (RA) and spondyloarthritis (SpA), are chronic inflammatory rheumatic diseases. Despite significant advancements in their management through novel therapies, some patients continue to experience flares or therapeutic resistance. Environmental factors, particularly smoking and air pollution, are known contributors to disease activity and progression. However, the role of air pollutants in exacerbating these diseases remains debated, especially in SpA.
Methods: This prospective study included 94 patients with stable RA (DAS28 < 3.2) or SpA (BASDAI < 4) recruited between January and May 2023. All patients were on stable biological therapies. Air pollutant levels (PM2.5, PM10, NO2, and O3) were obtained from AtmoSud, a regional air quality monitoring body. Exposure was calculated based on the patient’s residential location over a 6-month period, with a focus on the 2 months preceding the first flare for patients experiencing disease exacerbations. Statistical analyses, including logistic regression and ROC curve analysis, were used to explore the relationship between pollutant levels and disease flares.
Results: : Sixty-one patients (65%) experienced at least one flare during the study period. Patients with flares had significantly higher exposure to PM10 (29 µg/m3 vs. 18.4 µg/m3, p=0.0003) and PM2.5 (11.7 µg/m3 vs. 8.5 µg/m3, p=0.0004). Conversely, lower exposure to ozone (O3) was associated with flares (71.9 µg/m3 vs. 104.6 µg/m3, p=0.0004). No significant differences were found for NO2 exposure. The multivariate analysis confirmed these associations, and ROC curves identified flare thresholds of 20.6 µg/m3 for PM10 and 9.5 µg/m3 for PM2.5.
Conclusion: Our findings highlight the role of air pollution, particularly particulate matter (PM2.5 and PM10), in triggering disease flares in patients with RA and SpA. These results support the need for stricter air quality standards to mitigate the impact of environmental factors on inflammatory rheumatic diseases.
To cite this abstract in AMA style:
Cruzel C, Iannelli a, Armengaud A, Oppo S, Trojani M, Ferrero S, Breuil V, Fontas E, Roux C, Viala C. Air Pollution as a Trigger for Flares in Chronic Inflammatory Rheumatic Diseases: a Prospective Single-Center Study in the South of France [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/air-pollution-as-a-trigger-for-flares-in-chronic-inflammatory-rheumatic-diseases-a-prospective-single-center-study-in-the-south-of-france/. Accessed .« Back to ACR Convergence 2025
ACR Meeting Abstracts - https://acrabstracts.org/abstract/air-pollution-as-a-trigger-for-flares-in-chronic-inflammatory-rheumatic-diseases-a-prospective-single-center-study-in-the-south-of-france/