Do Smoking and Socioeconomic Factors Influence Imaging Outcomes in Axial Spondyloarthritis? Five-year Data From the DESIR Cohort

juin 20, 2020 | Posted by admin

Un nouvel article scientifique intitulé «Do Smoking and Socioeconomic Factors Influence Imaging Outcomes in Axial Spondyloarthritis? Five-year Data From the DESIR Cohort » a été publié dans le journal Arthritis Rheumatol.

Elena Nikiphorou, Sofia Ramiro, Alexandre Sepriano, Adeline Ruyssen Witrand, Robert B M Landewé, Désirée van der Heijde.

Abstract

Objectives: To investigate the relationship between smoking and imaging outcomes over 5 years in axSpA and assess if socioeconomic (SE) factors influence these relationships.

Methods: Patients with axSpA from the DESIR cohort were included. Four imaging outcomes (spine radiographs [modified Stoke Ankylosing Spondylitis Spine Score, mSASSS]; SIJ radiographs [modified New York grading, mNY]); MRI-Spine [Spondyloarthritis Research Consortium of Canada scoring, SPARCC] and MRI-SIJ [SPARCC]) were assessed by three central readers at baseline, 2 and 5-years. Explanatory variable of interest was smoking status at baseline. Interactions between smoking and SE factors (job type [blue- vs white-collar] and education [low vs high]) were first tested and if significant, analyses were run in separate strata. Generalized estimating equations models were used, adjusted for confounders.

Results: In total, 406 axSpA patients were included: 52% male, 40% smokers and 18% blue-collar. Smoking was independently associated with more MRI-SIJ inflammation at each visit over the 5-years, an effect that was seen only in blue-collar patients (β[95% CI]:5.41 [1.35,9.48]) and in patients with low education (β[95% CI]:2.65 [0.42, 4.88] (separate model). Smoking was also significantly associated with spinal inflammation (β[95% CI]:1.69 [0.45, 2.93] and SIJ damage (β[95% CI]:0.57 [0.18, 0.96] across all patients, irrespective of SE factors and other potential confounders.

Conclusion: Strong associations were found in particular between smoking at baseline and MRI-SIJ inflammation at each visit over 5-years in axSpA patients with blue-collar job or low education. These findings suggest a possible role for mechanical stress amplifying the effect of smoking on axial inflammation in axSpA.

Keywords: axial spondyloarthritis; imaging; inflammation; smoking; socioeconomic.

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