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dc.contributor.authorManfredsdottir, V F
dc.contributor.authorVikingsdottir, T
dc.contributor.authorJonsson, T
dc.contributor.authorGeirsson, A J
dc.contributor.authorKjartansson, O
dc.contributor.authorHeimisdottir, M
dc.contributor.authorSigurdardottir, S L
dc.contributor.authorValdimarsson, H
dc.contributor.authorVikingsson, A
dc.date.accessioned2009-03-30T11:46:01Z
dc.date.available2009-03-30T11:46:01Z
dc.date.issued2006-06-01
dc.date.submitted2009-03-30
dc.identifier.citationRheumatology (Oxford). 2006, 45(6):734-40en
dc.identifier.issn1462-0324
dc.identifier.pmid16403829
dc.identifier.doi10.1093/rheumatology/kei240
dc.identifier.urihttp://hdl.handle.net/2336/57855
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: To study the effect of tobacco smoking and rheumatoid factor (RF) isotypes on disease activity and joint damage in early rheumatoid arthritis (RA). METHODS: One hundred early RA patients were followed prospectively for 2 yr. They were evaluated at recruitment and at 6 and 24 months. Sociodemographic information included smoking history, and radiographs of hands and feet were obtained. RF was monitored by IgM- and IgA-specific RF enzyme-linked immunosorbent assay and by agglutination, and serial measurements were also obtained for C-reactive protein. The influence of tobacco smoking and RF positivity on disease outcome was evaluated using multivariate analysis. Covariates for the regression analysis included sex, age, coffee consumption and IgA-RF positivity. RESULTS: A gradient of increase in disease activity was observed from never smokers to former smokers to current smokers during the 2 yr of observation, defined by number of swollen joints (SJC), tender joints (TJC) and visual analogue scale for pain (P<0.001, P=0.02 and P=0.005, respectively), but smoking status did not influence radiological progression. Ever smokers were more often IgA RF positive (P<0.05). IgA RF-positive patients had more active disease (SJC P=0.002, TJC P=0.01) and showed more radiological progression (P<0.0001) compared with IgA RF-negative patients. Of the RF-positive patients 22% had elevated IgM RF without IgA RF and these patients showed similar disease activity and radiological joint progression to the RF-negative patients. None of these associations were explained by possible confounders. CONCLUSION: Tobacco smoking has an adverse effect on patients with early RA and this is possibly immunologically mediated. IgM RF does not predict poorer prognosis in RA unless it is associated with a concomitant elevation of IgA RF.
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://rheumatology.oxfordjournals.org/cgi/content/abstract/45/6/734en
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshBiological Markersen
dc.subject.meshDisease Progressionen
dc.subject.meshEpidemiologic Methodsen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshImmunoglobulin Aen
dc.subject.meshImmunoglobulin Men
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPain Measurementen
dc.subject.meshPrognosisen
dc.subject.meshRheumatoid Factoren
dc.subject.meshSeverity of Illness Indexen
dc.subject.meshSmokingen
dc.titleThe effects of tobacco smoking and rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritisen
dc.typeArticleen
dc.contributor.departmentDepartment of Immunology, Landspitali University Hospital, 101 Reykjavik, Iceland.en
dc.identifier.journalRheumatology (Oxford, England)en
html.description.abstractOBJECTIVE: To study the effect of tobacco smoking and rheumatoid factor (RF) isotypes on disease activity and joint damage in early rheumatoid arthritis (RA). METHODS: One hundred early RA patients were followed prospectively for 2 yr. They were evaluated at recruitment and at 6 and 24 months. Sociodemographic information included smoking history, and radiographs of hands and feet were obtained. RF was monitored by IgM- and IgA-specific RF enzyme-linked immunosorbent assay and by agglutination, and serial measurements were also obtained for C-reactive protein. The influence of tobacco smoking and RF positivity on disease outcome was evaluated using multivariate analysis. Covariates for the regression analysis included sex, age, coffee consumption and IgA-RF positivity. RESULTS: A gradient of increase in disease activity was observed from never smokers to former smokers to current smokers during the 2 yr of observation, defined by number of swollen joints (SJC), tender joints (TJC) and visual analogue scale for pain (P<0.001, P=0.02 and P=0.005, respectively), but smoking status did not influence radiological progression. Ever smokers were more often IgA RF positive (P<0.05). IgA RF-positive patients had more active disease (SJC P=0.002, TJC P=0.01) and showed more radiological progression (P<0.0001) compared with IgA RF-negative patients. Of the RF-positive patients 22% had elevated IgM RF without IgA RF and these patients showed similar disease activity and radiological joint progression to the RF-negative patients. None of these associations were explained by possible confounders. CONCLUSION: Tobacco smoking has an adverse effect on patients with early RA and this is possibly immunologically mediated. IgM RF does not predict poorer prognosis in RA unless it is associated with a concomitant elevation of IgA RF.


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