Background/Purpose: Moderate alcohol consumption is associated with a lower risk on RA development. (1,2) It is also associated with less severe systemic inflammation. Based on these data, we hypothesized that alcohol consumption is also associated with the severity of local inflammation in hand and foot joints at presentation of RA. Second, as symptom-free individuals also have a low degree of MRI-detected inflammation in MCP, wrist, and MTP joints (3), and because alcohol consumption is shown associated with C-reactive protein (CRP) levels in a J-shaped curve in the general population (4), we also supposed that alcohol consumption is associated with the severity of inflammation in small joints in symptom-free volunteers. The present large-scale MRI study was undertaken to evaluate these hypotheses.

Methods: MRI was performed at disease presentation in 171 RA-patients, included in the Leiden Early Arthritis Clinic (EAC) cohort and in 193 asymptomatic volunteers from the general population. Alcohol consumption was analysed as continuous measure and also categorized in four groups; non-drinkers, participants that consume 1-7 drinks/week, 8-14 drinks/week and >14 drinks/week and analysing a dose effect. A unilateral contrast-enhanced 1.5T MRI of MCP, wrist and MTP-joints was performed. Each MRI was scored by two readers on synovitis, bone marrow edema and tenosynovitis; the sum of these yielded the MRI inflammation score. Association of alcohol consumption with CRP was also evaluated. Kruskal Wallis test was used.

Results:  Although a J-shaped curve was seen in the association between alcohol consumption and CRP level in RA-patients, with the lowest levels in patients consuming 1-7 drinks a week (p=0.037), alcohol consumption was not associated with the severity of MRI-detected inflammation of hand and foot joints at presentation with RA (p=0.55). Also within asymptomatic volunteers alcohol consumption was not associated with the severity of local inflammation in hand and foot joints (p=0.33).

Conclusion: Despite the facts that other have shown that moderate alcohol consumption is protective to RA development and associated with less systemic inflammation in the general population, and that our data confirms a J-shaped association of alcohol consumption with CRP-levels in RA, there is no association between alcohol consumption and the severity of inflammation in hand and foot joints. The pathophysiological mechanism of the protective effect of alcohol is not well understood but the present data suggest that local inflammation is not involved. References: 1. Jin Z, Xiang C, Cai Q, Wei X, He J. Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a dose-response meta-analysis of prospective studies. Ann Rheum Dis2014;73:1962–1967. 2. Scott IC, Tan R, Stahl D, Steer S, Lewis CM, Cope AP. The protective effect of alcohol on developing rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology2013;52:856–867. 3. Mangnus L, Steenbergen H w. van, Reijnierse M, Helm-van Mil A h. m. van der. MR-detected features of inflammation and erosions occur in symptom-free persons from the general population. Arthritis Rheumatol2016:n/a-n/a. 4. Imhof A, Froehlich M, Brenner H, Boeing H, Pepys MB, Koenig W. Effect of alcohol consumption on systemic markers of inflammation. The Lancet 2001;357:763–767.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effects-of-alcohol-consumption-on-the-severity-of-inflammation-in-hand-and-foot-joints-detected-with-mr-imaging/