@article{3104137,
    title = "Smoking cessation is associated with lower disease activity and predicts cardiovascular risk reduction in rheumatoid arthritis patients",
    author = "Roelsgaard, I.K. and Ikdahl, E. and Rollefstad, S. and Wibetoe, G. and Esbensen, B.A. and Kitas, G.D. and Van Riel, P. and Gabriel, S. and Kvien, T.K. and Douglas, K. and Wållberg-Jonsson, S. and Rantapää Dahlqvist, S. and Karpouzas, G. and Dessein, P.H. and Tsang, L. and El-Gabalawy, H. and Hitchon, C.A. and Pascual-Ramos, V. and Contreras-Yáñez, I. and Sfikakis, P.P. and González-Gay, M.A. and Crowson, C.S. and Semb, A.G.",
    journal = "Rheumatology (United Kingdom)",
    year = "2020",
    volume = "59",
    number = "8",
    pages = "1997-2004",
    publisher = "Oxford University Press",
    doi = "10.1093/rheumatology/kez557",
    keywords = "antihypertensive agent;  antilipemic agent;  C reactive protein;  cyclooxygenase 2 inhibitor;  glucocorticoid;  high density lipoprotein cholesterol;  lipoprotein;  low density lipoprotein cholesterol;  nonsteroid antiinflammatory agent;  triacylglycerol;  lipoprotein, adult;  Article;  cardiovascular disease;  cardiovascular risk;  cohort analysis;  comparative study;  controlled study;  current smoker;  diastolic blood pressure;  disease activity;  disease association;  disease duration;  ex-smoker;  female;  follow up;  general condition deterioration;  human;  lipid fingerprinting;  major clinical study;  male;  medical information;  middle aged;  never smoker;  people by smoking status;  personal experience;  priority journal;  quality of life;  rheumatoid arthritis;  risk assessment;  risk factor;  smoking cessation;  systolic blood pressure;  adverse event;  aged;  blood;  blood pressure;  cardiovascular disease;  complication;  pathophysiology;  physiology;  rheumatoid arthritis;  risk reduction;  severity of illness index;  smoking, Adult;  Aged;  Arthritis, Rheumatoid;  Blood Pressure;  Cardiovascular Diseases;  Female;  Humans;  Lipoproteins;  Male;  Middle Aged;  Risk Factors;  Risk Reduction Behavior;  Severity of Illness Index;  Smoking;  Smoking Cessation",
    abstract = "Objectives: Smoking is a major risk factor for the development of both cardiovascular disease (CVD) and RA and may cause attenuated responses to anti-rheumatic treatments. Our aim was to compare disease activity, CVD risk factors and CVD event rates across smoking status in RA patients. Methods: Disease characteristics, CVD risk factors and relevant medications were recorded in RA patients without prior CVD from 10 countries (Norway, UK, Netherlands, USA, Sweden, Greece, South Africa, Spain, Canada and Mexico). Information on CVD events was collected. Adjusted analysis of variance, logistic regression and Cox models were applied to compare RA disease activity (DAS28), CVD risk factors and event rates across categories of smoking status. Results: Of the 3311 RA patients (1012 former, 887 current and 1412 never smokers), 235 experienced CVD events during a median follow-up of 3.5 years (interquartile range 2.5-6.1). At enrolment, current smokers were more likely to have moderate or high disease activity compared with former and never smokers (P < 0.001 for both). There was a gradient of worsening CVD risk factor profiles (lipoproteins and blood pressure) from never to former to current smokers. Furthermore, former and never smokers had significantly lower CVD event rates compared with current smokers [hazard ratio 0.70 (95% CI 0.51, 0.95), P = 0.02 and 0.48 (0.34, 0.69), P < 0.001, respectively]. The CVD event rates for former and never smokers were comparable. Conclusion: Smoking cessation in patients with RA was associated with lower disease activity and improved lipid profiles and was a predictor of reduced rates of CVD events. © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology."
}