Session Type: Abstract Submissions (ACR)
Several studies have shown that smoking is associated with increased disease activity, worse physical function and poor quality of life in ankylosing spondylitis (AS). However, other than as part of general health advice, recommendations on smoking cessation are not commonly given by physicians, nor perceived as of high importance by AS patients. The aim of the current study was to examine the effect of smoking cessation on various clinical and patient-reported parameters in AS.
SIRAS collects data on clinically diagnosed AS patients in Scotland. Clinical measures are obtained from medical records, and postal questionnaires provide patient-reported data, including smoking status and quality of life. Differences between current and ex-smokers were assessed using linear regression models, adjusted for potential confounders (age, sex, education, socio-economic status, and alcohol consumption). Results are given as regression coefficients with 95% Confidence Intervals.
SIRAS includes clinical and patient-reported information on 959 AS patients: 73% male; mean age 52yrs; 22% current smokers and 38% ex-smokers. Compared to current smokers, ex-smokers initially reported significantly lower disease activity (BASDAI) and physical function (BASFI) scores (-0.7 (-1.2, -0.2) and -0.4 (-0.95, 0.2), however, after adjusting for potential confounders this was no longer statistically significant (although still lower): -0.4 (-0.98, 0.1), and -0.4 (-0.97, 0.3), respectively. Additionally, ex-smokers reported significantly better quality of life: ASQoL score -1.4 (-2.5, -0.4). There were no other statistically significant differences between current and ex-smokers with any other clinical or patient-reported outcome.
Ex-smokers with AS, in comparison to smokers, have lower disease activity and function in addition to better disease-related quality of life. For comparison, the difference in disease activity is around 30% of the expected effect one might achieve with intensive physiotherapy, and 16% that of biologic therapy. Rather than being part of generic health advice, clinicians should actively promote smoking cessation as an adjunct to usual therapy.
L. E. Dean,
A. G. MacDonald,
R. D. Sturrock,
Novartis Pharmaceutical Corporation,
G. J. Macfarlane,
G. T. Jones,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-clinical-parameters-and-quality-of-life-in-smokers-with-ankylosing-spondylitis-results-from-the-scotland-registry-for-ankylosing-spondylitis/