Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study

Larsson, Ingrid; Andersson, Maria

doi:10.1136/bmjopen-2018-024367

Cited by 12 publications

(7 citation statements)

References 45 publications

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“…Another important reason justifying a recommended reduced alcohol consumption in RA is the indirect effects on bone tissue, which are related to the dose and duration of consumption. While moderate consumption (1–2 drinks per day) does not appear to be harmful to bone tissues, increased consumption could irreversibly damage bones and tendons [ 127 ].…”

Section: The Impact Of Lifestyle Changes In Ramentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

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Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease that affects about 1% of the global population, with a female–male ratio of 3:1. RA preferably affects the joints, with consequent joint swelling and deformities followed by ankylosis. However, evidence has accumulated showing that patients suffering from RA can also develop extra-articular manifestations, including cardiovascular disease states, neuropathies, and multiorgan dysfunction. In particular, peripheral nerve disorders showed a consistent impact in the course of the disease (prevalence about 20%) mostly associated to vasculitis of the nerve vessels leading to vascular ischemia, axonal degeneration, and neuronal demyelination. The pathophysiological basis of this RA-associated microvascular disease, which leads to impairment of assonal functionality, is still to be better clarified. However, endothelial dysfunction and alterations of the so-called brain-nerve barrier (BNB) seem to play a fundamental role. This review aims to assess the potential mechanisms underlying the impairment of endothelial cell functionality in the development of RA and to identify the role of dysfunctional endothelium as a causative mechanism of extra-articular manifestation of RA. On the other hand, the potential impact of lifestyle and nutritional interventions targeting the maintenance of endothelial cell integrity in patients with RA will be discussed as a potential option when approaching therapeutic solutions in the course of the disease.

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Section: The Impact Of Lifestyle Changes In Ramentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

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“…Based on the questionnaire of 2010 it was found that 6% of the patients had stopped drinking. By qualitative content analyses, we found that patients who stopped drinking were older, had lower health-related quality of life, more pain and fatigue and worse physical function compared with those who continued drinking 40. The reasons for stopping drinking alcohol varied but was most often illness.…”

Section: Major Resultsmentioning

confidence: 95%

“…The reasons for stopping drinking alcohol varied but was most often illness. Another reason was a desire to improve health and well-being and, less frequently, the patients referred to work and solidarity with family members 40…”

Section: Major Resultsmentioning

confidence: 99%

<p>A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis – results of clinical relevance</p>

Hafström¹,

Ajeganova²,

Andersson³

et al. 2019

OARRR

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PurposeAt the end of the twentieth century, the outcome of rheumatoid arthritis (RA) was shown to be unsatisfactory and new therapeutic strategies were introduced. This initiated a register-based long-term study of early RA, the Better Anti-Rheumatic PharmacOTherapy (BARFOT) study. The aims were to evaluate the disease course and to acquire knowledge for improved care.Patients and methodsBARFOT is a multicentre observational study of patients with early RA, consecutively included 1992–2006. The patients are followed in daily practice according to a structured protocol for 15 years and data recorded in a web-based register. Also, through linkage of the BARFOT register to national registers we have acquired information on comorbidity and mortality.ResultsIn all, 2857 patients have been included and over 80 scientific articles have been published. Phenotypic characteristics at disease onset, i.e. gender, smoking habits and autoantibody profiles have been addressed. The disease course over 15 years was described. Early predictors for persistent disease activity, impaired function, joint damage and co-morbidities have been identified. Treatment strategies have been studied. A randomized sub-study gave strong support for the treatment of recent RA with low-dose prednisolone in combination with disease-modifying anti-rheumatic drug. Furthermore, the impact of lifestyle factors, such as smoking, alcohol consumption, body weight and physical activity has been addressed.ConclusionA register-based study like BARFOT has provided a basis for optimal long-term management of patients with RA. In addition, the register has made it possible to perform a diversity of studies of RA addressing various issues of major relevance to the patients.

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“…[7][8][9] One study linked alcohol consumption to increased radiological progression, however others associate drinking with milder disease activity. [10][11][12] This study examines the effects of alcohol consumption and its associations with remission and disease activity among 979 patients with inflammatory arthritis. Of the patients 64.2% were in remission.…”

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 99%

The effects of alcohol consumption and its associations with disease activity among 979 patients with inflammatory arthritis

et al. 2021

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ObjectiveThe role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis.MethodsPatients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on demographics, alcohol use, smoking habits and disease outcome measures were collected from these patients. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann-Whitney U tests and one-way analysis of variance with Tukey’s honest significant difference (HSD) test.ResultsOf the 979 analysed patients, 62% had rheumatoid arthritis (RA), 26.7% had psoriatic arthritis (PsA) and 11.2% had ankylosing spondylitis. Mean DAS28-CRP (Disease Activity Score 28 - C-reactive protein) in RA and PsA at 1 year was 2.96±1.39, and 64.2% of patients were in remission (DAS28-CRP ≤2.6 or BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) ≤4). Both male gender and risky drinking (>15 units of weekly alcohol) were significantly associated with remission. Compared with women, men had an OR of 1.8 (1.1, 2.5) (p=0.034) for any alcohol consumption and 6.9 (4.7, 9.1) (p=0.001) for drinking at least 15 weekly drinks. When adjusted for gender, there was no association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still significantly influenced disease activity.ConclusionWhile it may appear that alcohol is linked to remission in inflammatory arthritis, when adjusted for gender, it is not. Men with inflammatory arthritis drink significantly more than women and have less severe disease activity.

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Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study

Cited by 12 publications

References 45 publications

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

<p>A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis – results of clinical relevance</p>

The effects of alcohol consumption and its associations with disease activity among 979 patients with inflammatory arthritis

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