Smoking and Knee and Hip Osteoarthritis Evolution. Results from the Knee and Hip Osteoarthritis Long-Terme Assessment Cohort

christian roux¹, joel Coste², Bernard Mazieres³, Coralie Roger⁴, eric Fontas⁵, Bruno fautrel⁶, Jacques Pouchot^7,8, Patrice Fardellone^9,10, Anne-Christine Rat^11,12, alain Saraux¹³, Francis Guillemin¹⁴ and Liana Euller Ziegler¹⁵, ¹Rheumatology, LAMHESS laboratory, sofia antipolis university, CHU Pasteur 2, Nice, France, nice, France, ²Biostatistique, Unité INSERM 875, Hotel Dieu, Paris, france, Paris, France, ³Rheumatology department, Hospital Toulouse, france, toulouse, France, ⁴Direction recherche clinique, Hopital universitaire de Nice, nice, France, ⁵Direction recherche clinique, CHU de Nice, france, Nice, France, ⁶rheumatology department, Hospital Pitié Salpétrière, Paris, france, Paris, France, ⁷internal medicine, Hôpital Européen Georges Pompidou, AP-HP, Paris, France, ⁸Paris University, Internal medicine, Paris, France, ⁹Rheumatology, Hopital Nord Amiens, Amiens, France, ¹⁰Department of Rheumatology, Amiens University hospital, Amiens, France, ¹¹CHU Nancy, Clinical Epidemiology and Evaluation, Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France, ¹²Service de Rhumatologie, Nancy-University, Paris Descartes, Metz P Verlaine, EA 4003; Department of clinical epidemiology and evaluation, Nancy University Hospital; Department of rheumatology, Nancy University Hospital, Vandoeuvre les Nancy, France, ¹³Rheumatology Department, CHU la cavale Blanche, brest, france, Brest, France, ¹⁴Department of Clinical Epidemiology and Evaluation, Nancy University Hospital, Nancy-University, EA 4003, Nancy, France, ¹⁵151 rte de St Antoine de Gines, CHU de Nice -Université Nice Sophia Antipolis, Nice, France

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Hip, Knee, Osteoarthritis and radiology

Session Information

Date: Sunday, November 8, 2015

Title: Osteoarthritis - Clinical Aspects Poster I: Treatments and Metabolic Risk Factors

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Relations between smoking and osteoarthritis remains discussed. The protective effect found in previous epidemiological studies has not been confirmed by recent studies and meta analyses. This study aims to investigate the effect of smoking on pain, function and structural evolution in hip and knee symptomatic osteoarthritis.

Methods:

The subjects studied were enrolled in the KHOALA cohort (Knee and Hip OsteoArthritis Long-term Assessment) which has been described in detail elsewhere. Briefly, it is a population-based cohort of 878 subjects aged from 40 to 75 years with symptomatic lower limb OA (knee and/or hip). Data were collected at baseline and after three years during an outpatient visit, and each year with self-administered questionnaires. The data collected included demographic characteristics, and annual data for pain (0-100), function (Harris Hip Score and Womac), smoking information (duration, amount and ongoing). Standard radiographs of both hips were obtained at baseline and at three years. The progression of hip and or knee osteoarthritis was evaluated according to the radiological Kellgren-Lawrence score (KL), osteophytes scores (0-3) per location and swelling. Univariate and multivariate statistical analysis were performed adjusted on age, BMI, sex and diabetes. the subjects were divided into smokers, non-smokers and former smokers.

Results:

873 subjects have been included, 119 smokers, 215 former smokers et 539 non-smokers, 64% of smokers and 31 % of former smokers have smoked during over 20 years. 40% of smokers have smoked 20 pack years. 20 subjects were not taken into account due to lack of data. Baseline characteristics are presented in table with comparisons between baseline and 3 years

At 3 years, no difference has been shown between different groups about function, pain and structural evolution for the hip (0.16) and knee (p=0.9) as for the laying prosthesis (p=0.4 and p=0.5). But smokers (OR=0.33 [0.11-1.09]) and former smokers (OR=0.30[0.1-0.85]) developed fewer osteophytes only in the knee either in medial and lateral condyles (p=0.037 and 0.07). The dose of intoxication (p = 0.026 (OR = 0.98 [0.97-1]) and the duration of intoxication (p = 0.0005 (OR = 0.98 [0.97-0.99]) were significantly associated with the development of these osteophytes. No difference is found for other structural parameters.

Conclusion:

Our results shows that smoking does not influence function and pain but smokers and ancient smokers seems to develop less osteophytesat femoral level. As a possible explanation, recent experimental studies have shown that nicotine upregulated collagen synthesis, chondrocytes proliferation and influences TGFβ synthesis which is involved in the formation of osteophytes.these results needs to be confirmed.

	Smokers Baseline	former smokers Baseline	Non mokers Baseline	P*	P**	P***
Age mean (SD)	57 (9)	62 (8)	63 (8)	0.0001
BMI mean (SD)	28.2 (6)	29.1 (6)	29.8 (6)	0.009
Knee Pain (0-100) median	30	25	35	0.01	NS	NS
Knee Function (womac) median	28.1	25	31.3	0.03	NS	NS
Smoking dose (pack-year) mean (SD)	21 (16)	16 (15)
Smoking duration (years) mean (SD)	29 (13)	19 (12)
Knee OA KL≥2 n (%)	79 (94)	148 (92.5)	376 (82.2)	NS	NS	NS
Knee Osteophytes MC n(%)	45 (53.6)	87 (54.4)	239 (58.6)	NS	0.03	0.04
Knee osteophytes LC n (%)	17 (20.2)	42 (26.3)	129 (31.6)	0.04	0.05	0.06
Knee osteophytes MP n (%)	29 (35)	64 (40)	169 (41)	0.4	NS	NS
Knee osteophytes LP n (%)	52 (62)	95 (59)	245 (60)	0.9	NS	NS
Hip OA KL≥2 n (%)	(38.5)	(27.9)	(29)	0.01	NS	NS
Hip function (Harris) median	84	78.9	80	NS	NS	NS

Disclosure: C. roux, None; J. Coste, None; B. Mazieres, None; C. Roger, None; E. Fontas, None; B. fautrel, None; J. Pouchot, None; P. Fardellone, None; A. C. Rat, None; A. Saraux, None; F. Guillemin, None; L. Euller Ziegler, None.

To cite this abstract in AMA style:

roux C, Coste J, Mazieres B, Roger C, Fontas E, fautrel B, Pouchot J, Fardellone P, Rat AC, Saraux A, Guillemin F, Euller Ziegler L. Smoking and Knee and Hip Osteoarthritis Evolution. Results from the Knee and Hip Osteoarthritis Long-Terme Assessment Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/smoking-and-knee-and-hip-osteoarthritis-evolution-results-from-the-knee-and-hip-osteoarthritis-long-terme-assessment-cohort/. Accessed .

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