Smoking, alcohol consumption and disease-specific outcomes in rheumatic and musculoskeletal diseases (RMDs): systematic reviews informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

RMD Open - Tập 8 Số 1 - Trang e002170 - 2022
M. Wieczorek1,2, James M. Gwinnutt3, Maxime Ransay-Colle2, Andra Bălănescu4, Heike A. Bischoff‐Ferrari1,5,6, Annelies Boonen7,8, Giulio Cavalli9, Savia de Souza10, Annette de Thurah11,12, Thomas E. Dorner13,14,15, Rikke Helene Moe16, Polina Putrik7,8, Javier Rodríguez‐Carrio17,18, Lucía Silva-Fernández19, Tanja Stamm20,21, Karen Walker‐Bone22, Joep Welling23, Mirjana Zlatković‐Švenda24,25, Suzanne Verstappen3,22,26, Françis Guillemin27,2
1Centre on Aging and Mobility, University Hospital Zurich, Zurich City Hospital - Waid and University of Zurich, Zurich, Switzerland
2EA4360 Apemac, University of Lorraine, Vandoeuvre-lès-Nancy, France
3Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
4Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
5Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
6University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
7Care and Public Health Research Institute (CAPHRI), Maastricht Univeristy, Maastricht, The Netherlands
8Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center+, Maastricht, the Netherlands
9Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
10Centre for Rheumatic Diseases, King’s College London, London, UK
11Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
12Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
13Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
14Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
15Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria
16National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
17Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain
18Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
19Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
20Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
21Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
22MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
23NVLE Dutch patient organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
24Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
25Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia
26NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
27CIC-1433 Epidemiologie Clinique, Inserm, CHRU Nancy, University of Lorraine, Nancy, France

Tóm tắt

BackgroundA EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). The aim of this paper was to review the literature on the relationship between smoking and alcohol consumption with regard to RMD-specific outcomes.MethodsTwo systematic reviews were conducted to identify systematic reviews and meta-analyses, published between 2013 and 2018, related to smoking and alcohol consumption in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic sclerosis (SSc) and gout. Two additional systematic reviews were performed to identify original longitudinal studies on smoking and alcohol consumption and disease-specific outcomes.ResultsNine reviews and 65 original studies on smoking as well as two reviews and 14 original studies on alcohol consumption met the inclusion criteria. While most studies were moderate/poor quality, smoking was significantly associated with poorer outcomes: cardiovascular comorbidity; poorer response to RA treatment; higher disease activity and severity in early RA; axSpA radiographic progression. Results were heterogeneous for OA while there was limited evidence for PsA, SSc and gout. Available studies on alcohol mainly focused on RA, reporting a positive association between alcohol intake and radiographic progression. Five studies assessed alcohol consumption in gout, reporting a significant association between the number and type of alcoholic beverages and the occurrence of flares.ConclusionCurrent literature supports that smoking has a negative impact on several RMD-specific outcomes and that moderate or high alcohol consumption is associated with increased risk of flares in RA and gout.

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