Smoking Is Associated with Higher Disease Activity in Rheumatoid Arthritis: A Longitudinal Study Controlling for Time-varying Covariates.

Aged Antirheumatic Agents / therapeutic use Arthritis, Rheumatoid / drug therapy Female Follow-Up Studies Hospitals, Public Humans Longitudinal Studies Lost to Follow-Up Male Middle Aged Risk Factors Severity of Illness Index Smoking / adverse effects
DISEASE ACTIVITY EPIDEMIOLOGY RHEUMATOID ARTHRITIS SMOKING

Journal

The Journal of rheumatology
ISSN: 0315-162X
Titre abrégé: J Rheumatol
Pays: Canada
ID NLM: 7501984

Informations de publication

Date de publication:
04 2019
Historique:
accepted: 10 08 2018
pubmed: 7 12 2018
medline: 9 6 2020
entrez: 4 12 2018
Statut: ppublish

Résumé

Prior studies around the relationship between smoking and rheumatoid arthritis (RA) disease activity have reported inconsistent findings, which may be ascribed to heterogeneous study designs or biases in statistical analyses. We examined the association between smoking and RA outcomes using statistical methods that account for time-varying confounding and loss to followup. We included 282 individuals with an RA diagnosis using electronic health record data collected at a public hospital between 2013 and 2017. Current smoking status and disease activity were assessed at each visit; covariates included sex, race/ethnicity, age, obesity, and medication use. We used longitudinal targeted maximum likelihood estimation to estimate the causal effect of smoking on disease activity measures at 27 months, and compared results to conventional longitudinal methods. Smoking was associated with an increase of 0.64 units in the patient global score compared to nonsmoking (p = 0.01), and with 2.58 more swollen joints (p < 0.001). While smoking was associated with a higher clinical disease activity score (2.11), the difference was not statistically significant (p = 0.22). We found no association between smoking and physician global score, or C-reactive protein levels, and an inverse association between smoking and tender joint count (p = 0.05). Analyses using conventional methods showed a null relationship for all outcomes. Smoking is associated with higher levels of disease activity in RA. Causal methods may be useful for investigations of additional exposures on longitudinal outcome measures in rheumatologic disease.

Identifiants

DOI: 10.3899/jrheum.180262 PMID: 30504507 PMC: PMC6445683
pubmed: 30504507
pii: jrheum.180262
doi: 10.3899/jrheum.180262
pmc: PMC6445683
mid: NIHMS1007372
doi:

Substances chimiques

Antirheumatic Agents 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

370-375

Subventions

Organisme : NIAMS NIH HHS
ID : K24 AR074534
Pays : United States
Organisme : NIAMS NIH HHS
ID : K23 AR063770
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS024412
Pays : United States
Organisme : NIAMS NIH HHS
ID : P30 AR070155
Pays : United States
Organisme : NIAMS NIH HHS
ID : F32 AR070585
Pays : United States

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Auteurs

Milena A Gianfrancesco (MA)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA. Milena.Gianfrancesco@ucsf.edu.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA. Milena.Gianfrancesco@ucsf.edu.
ORCID: 0000-0002-8351-4626

Laura Trupin (L)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.
ORCID: 0000-0003-4046-200X

Stephen Shiboski (S)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.
ORCID: 0000-0002-9257-2609

Mark van der Laan (M)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.

Jonathan Graf (J)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.

John Imboden (J)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.

Jinoos Yazdany (J)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.
ORCID: 0000-0002-3508-4094

Gabriela Schmajuk (G)

From the Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
M.A. Gianfrancesco, PhD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; L. Trupin, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; S. Shiboski, PhD, Department of Epidemiology and Biostatistics, University of California, San Francisco; M. van der Laan, PhD, Division of Biostatistics, School of Public Health, University of California, Berkeley; J. Graf, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Imboden, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco; J. Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco; G. Schmajuk, MD, MS, Division of Rheumatology, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California, USA.
ORCID: 0000-0003-2687-5043

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Classifications MeSH

Recherchemedicale.com › Personnes › Tranches d'âge › Adulte › Sujet âgé › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Antirhumatismaux › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Maladies du système immunitaire › Maladies auto-immunes › Polyarthrite rhumatoïde › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Hôpitaux publics › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études longitudinales › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Techniques d'investigation › Perdus de vue › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Smoking Is Associated with Higher Disease...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Smoking Is Associated with Higher Disease...
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