The effect of alcohol on radiographic progression in rheumatoid arthritis

Article Article scientifique Article The effect of alcohol on radiographic progression in rheumatoid arthritis eng 2010 author Nissen Michaël 708146 Michael John Nissen author Gabay Cem 70978 author Scherer Anna 728701 author Finckh Axel 22454 1265-1272 10.1002/art.27388 20213811 0004-3591 http://onlinelibrary.wiley.com/store/10.1002/art.27388/asset/27388_ftp.pdf?v=1&t=h1qhgqui&s=880e110369aeea314d87bceab03d4ca98d477797 OBJECTIVE: Alcohol consumption reduces the risk of development of rheumatoid arthritis (RA) and significantly attenuates the development of erosive arthritis in animal models. It remains unknown whether alcohol consumption influences joint damage progression in RA. This study was undertaken to compare the rates of radiographic damage progression in alcohol drinkers and nondrinkers in a large prospective cohort of patients with RA. METHODS: All patients in the population-based Swiss Clinical Quality Management in RA registry database with at least 2 sequential radiographs were included. Joint erosions were assessed in 38 joints in the hands and feet using a validated scoring method. The rate of progression of erosions was analyzed using multivariate regression models for longitudinal data and was adjusted for potential confounders. RESULTS: The study included 2,908 patients with RA with a mean of 4 sequential radiographs and 3.9 years of followup. A trend toward reduced radiographic progression existed in drinkers compared with nondrinkers, with a mean rate of erosive progression of 0.99% (95% confidence interval [95% CI] 0.89-1.09) and 1.13% (95% CI 1.01-1.26) at 1 year, respectively. Alcohol consumption displayed a J-shaped dose-response effect, with a more favorable evolution in occasional consumers (P = 0.01) and daily consumers (P = 0.001) as compared with nondrinkers, while heavy drinkers demonstrated worse radiographic evolution (P = 0.0001). We found significant effect modification by sex, with male drinkers displaying significantly less erosive progression compared with male nondrinkers (mean 0.86% [95% CI 0.70-1.03] versus 1.35% [95% CI 1.02-1.67]; P = 0.007). CONCLUSION: Our findings indicate a trend toward reduced radiographic progression in alcohol drinkers compared with nondrinkers, specifically in occasional and daily alcohol consumers. In particular, male patients with RA who consume alcohol demonstrate less radiographic progression than do male nondrinkers. Alcohol Drinking/*epidemiology Antirheumatic Agents/therapeutic use Arthritis, Rheumatoid/drug therapy/*epidemiology/*radiography Disability Evaluation Disease Progression Female Humans Male Middle Aged Prospective Studies Registries/*statistics & numerical data Risk Factors Risk Reduction Behavior Sex Distribution Switzerland/epidemiology Dewey 616 56 Département de médecine 221 false 28 Mécanisme de l'inflammation articulaire 44 Arthritis and rheumatism 62 5 73250113-4bbc-43e9-8f93-c2d238c3e642 Article Restricted file1.pdf 151549 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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The effect of alcohol on radiographic progression in rheumatoid arthritis	Arthritis and rheumatism			2010	541	0

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Scherer, Anna