Disease Severity in Never Smokers, Ex-Smokers, and Current Smokers With Axial Spondyloarthritis

Results From the Scotland Registry for Ankylosing Spondylitis

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Abstract

Objective

To examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.
Methods

The Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results

Data were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95% CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95% CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]).
Conclusion

Smokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.
Original languageEnglish
Pages (from-to)1407-1413
Number of pages87
JournalArthritis Care & Research
Volume69
Issue number9
Early online date13 Aug 2017
DOIs
Publication statusPublished - Sep 2017

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Ankylosing Spondylitis
Scotland
Registries
Quality of Life
Baths
Confidence Intervals
Smoking Cessation
Smoking
Odds Ratio
Sex Education
Uveitis
Medical Records
Linear Models
Logistic Models
Alcohols
Exercise
Surveys and Questionnaires

Keywords

  • Spondyloarthritis
  • smoking cessation
  • disease severity

Cite this

@article{00f565bb489b4b3ebb47d9e81c11af26,
title = "Disease Severity in Never Smokers, Ex-Smokers, and Current Smokers With Axial Spondyloarthritis: Results From the Scotland Registry for Ankylosing Spondylitis",
abstract = "ObjectiveTo examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.MethodsThe Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95{\%} confidence intervals (95{\%} CIs).ResultsData were obtained from 946 participants (73.5{\%} male, mean age 52 years). Current smoking was reported by 22{\%}, and 38{\%} were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95{\%} CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95{\%} CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95{\%} CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95{\%} CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95{\%} CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95{\%} CI 1.5, 3.8]).ConclusionSmokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.",
keywords = "Spondyloarthritis , smoking cessation, disease severity",
author = "Jones, {Gareth T} and Tiara Ratz and Dean, {Linda E} and MacFarlane, {Gary J} and Fabiola Atzeni",
note = "ACKNOWLEDGEMENTS We would like to thank all the clinicians and research nurses who facilitated recruitment and data collection. In particular we would like to thank the SIRAS steering committee, especially Professor Roger Sturrock (chair) and Dr David Marshall (vice-chair). We would also like to thank the SIRAS coordinating centre study team, in particular Elizabeth Jones, Giles O’Donovan, Nabi Moaven-Hashemi and Flora Joyce. GTJ, GJM and FA conceived of the study. The initially analysis was undertaken by TR, under the supervision of GTJ and LED. GTJ produced the first draft of the manuscript and all authors have provided intellectual input into its revision. Funding SIRAS was funded by unrestricted grant from Pfizer and AbbVie.",
year = "2017",
month = "9",
doi = "10.1002/acr.23157",
language = "English",
volume = "69",
pages = "1407--1413",
journal = "Arthritis Care & Research",
issn = "0893-7524",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Disease Severity in Never Smokers, Ex-Smokers, and Current Smokers With Axial Spondyloarthritis

T2 - Results From the Scotland Registry for Ankylosing Spondylitis

AU - Jones, Gareth T

AU - Ratz, Tiara

AU - Dean, Linda E

AU - MacFarlane, Gary J

AU - Atzeni, Fabiola

N1 - ACKNOWLEDGEMENTS We would like to thank all the clinicians and research nurses who facilitated recruitment and data collection. In particular we would like to thank the SIRAS steering committee, especially Professor Roger Sturrock (chair) and Dr David Marshall (vice-chair). We would also like to thank the SIRAS coordinating centre study team, in particular Elizabeth Jones, Giles O’Donovan, Nabi Moaven-Hashemi and Flora Joyce. GTJ, GJM and FA conceived of the study. The initially analysis was undertaken by TR, under the supervision of GTJ and LED. GTJ produced the first draft of the manuscript and all authors have provided intellectual input into its revision. Funding SIRAS was funded by unrestricted grant from Pfizer and AbbVie.

PY - 2017/9

Y1 - 2017/9

N2 - ObjectiveTo examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.MethodsThe Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs).ResultsData were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95% CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95% CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]).ConclusionSmokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.

AB - ObjectiveTo examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.MethodsThe Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs).ResultsData were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95% CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95% CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]).ConclusionSmokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.

KW - Spondyloarthritis

KW - smoking cessation

KW - disease severity

U2 - 10.1002/acr.23157

DO - 10.1002/acr.23157

M3 - Article

VL - 69

SP - 1407

EP - 1413

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 0893-7524

IS - 9

ER -