Smoking Worsens Axial Spondyloarthritis Symptoms

Individuals with axial spondyloarthritis who smoke are negatively affecting their disease by worsening fatigue, sleep, anxiety, and depression, as well as heightening the odds for psoriasis, according to a new study.

To determine whether smoking is independently associated with a worsened disease profile in axial spondyloarthritis, the researchers analyzed baseline data from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis.

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Extra-axial manifestations and other disease severity measures, including scales for fatigue, sleep, anxiety, and depression, were compared with the participants’ smoking status and how often they smoke.

A total of 2031 participants were included in the study. Of these, 24% were current smokers and 32% were ex-smokers.

When compared with non-smokers, current smokers had lower odds of uveitis and higher odds of psoriasis.

Former smokers and those who currently smoke had incrementally more severe disease than those who never smoked and presented with higher Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. Fatigue, sleep, anxiety, and depression showed similar associations.

“The paradoxical association between current smoking and reduced odds of uveitis is interesting and warrants further investigation,” the researchers concluded.

—Colleen Murphy

Reference:

Zhao S, Jones GT, Macfarlane GJ, et al. Associations between smoking and extra-axial manifestations and disease severity in axial spondyloarthritis: results from the BSR Biologics Register for Ankylosing Spondylitis (BSRBR-AS) [published online December 14, 2018]. Rheumatology. https://doi.org/10.1093/rheumatology/key371.