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

Wieczorek, M.; Gwinnutt, James M; Ransay-Colle, Maxime; Bălănescu, Andra; Bischoff‐Ferrari, Heike A.; Boonen, Annelies; Cavalli, Giulio; Souza, Savia de; Thurah, Annette de; Dörner, Thomas; Moe, Rikke Helene; Putrik, Polina; Rodríguez‐Carrio, Javier; Silva-Fernández, Lucía; Stamm, Tanja; Walker‐Bone, Karen; Welling, Joep; Zlatković-Švenda, Mirjana; Verstappen, Suzanne; Guillemin, Françis

doi:10.1136/rmdopen-2021-002170

Cited by 52 publications

(29 citation statements)

References 97 publications

(102 reference statements)

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“…From March 2019 to May 2019, systematic reviews of original research were conducted, one for each of the six predefined exposures (excluding OA for certain exposures, as mentioned above) 18–21. Population, Intervention, Comparison, Outcome (PICO) strategies were written and search strategies were developed for each review.…”

Section: Methodsmentioning

confidence: 99%

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

et al. 2022

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ObjectivesA European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs).MethodsSix lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed.ResultsFive overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations.ConclusionsThese recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.

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Section: Methodsmentioning

confidence: 99%

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

et al. 2022

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“…Some studies found that cigarette smoking was associated with more SJC, TJC, higher VAS for pain and disease activity score [ 36 , 37 ], positivity of RF [ 37 , 38 ] and ACPA [ 38 ], more severe joint damage progression [ 37 , 39 ], and poorer response to first-line DMARDs [ 40 ]. But there were also contrary results from different cohorts [ 8 ]. In our study, smokers were characterized by a higher ESR and a higher positive rate of RF.…”

Section: Discussionmentioning

confidence: 94%

“…Previous studies have shown that cigarette smoking is associated with the prevalence of RA-ILD, combined pulmonary fibrosis and emphysema, rheumatoid nodules [ 1 ], and a poorer prognosis in both RA patients [ 8 ] and RA-ILD patients [ 9 , 10 ]. However, the impact of cigarette smoking on different patterns of lung involvements has not been studied in well-matched cohorts of RA patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of cigarette smoking on rheumatoid arthritis-associated lung diseases: a retrospective case control study on clinical and radiological features and prognosis

et al. 2022

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Our study aimed to investigate the clinical and radiological features and prognosis of male smoker patients with rheumatoid arthritis (RA). We consecutively enrolled male inpatients with RA who received chest HRCT during hospitalization in Peking University Third Hospital from Jan 1st, 2012 to August 1st, 2021. 154 male patients with RA were eligible for analysis, of whom 76.6% ( n = 118) were current smokers or had a history of cigarette smoking. Compared to never-smokers, smoker patients had more respiratory symptoms, including cough (31.4% vs 5.6%, p = 0.002) and sputum production (26.3% vs 2.8%, p = 0.002), and a higher positive rate of rheumatoid factor (RF) (77.6% vs 58.8%, p = 0.030). A higher percentage of smoker patients showed emphysema (45.8% vs 16.7%, p = 0.002) and signs of lung fibrosis (51/54, 94.4% vs 7/13, 53.8%, p < 0.001) in those with interstitial lung disease (ILD, n = 67) on chest HRCT. The overall survival rate was different between smoker and never-smoker patients ( p = 0.031), but instead of cigarette smoking, lung fibrosis on HRCT was the risk factor for survival of our patients. In conclusion, male patients with RA who were current smokers or had a history of cigarette smoking presented more respiratory symptoms and a higher positive rate of RF. They also showed more emphysema and signs of lung fibrosis on chest HRCT. Cigarette smoking impacted on the overall survival as a confounding factor in this cohort of male patients with RA. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-022-05219-9.

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“…A recent systematic review dealt with smoking and alcohol consumption in patients with rheumatic and musculoskeletal diseases (RMD), amongst others with gout. While tobacco use does not seem to have an influence on gout attacks or SUA, alcohol consumption showed a significant association between the number and type of alcoholic beverages and the occurrence of flares [ 37 ]; however, to account for cultural differences in this context studies focusing on ethnicity and geographical residence are still lacking but needed. Sugary soft drinks, fruit juices and high-fructose foods (fruit sugars) can increase SUA levels and should therefore be avoided.…”

Section: Resultsmentioning

confidence: 99%

2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia

Sautner

Eichbauer-Sturm²,

Gruber

et al. 2022

Wien Klin Wochenschr

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Summary Background Gout is the most frequent inflammatory joint disease in the western world and has a proven genetic background. Additionally, lifestyle factors like increasing life span and wealth, sufficient to excess nutritional status and a growing prevalence of obesity in the population, as well as e.g. alcohol consumption contribute to the rising incidence of hyperuricemia and gout. Apart from an adequate medication, medical advice on nutrition and lifestyle is an essential part of the management of gout patients, being at high risk of internal comorbidities. Objective In 2015, the ÖGR (Österreichische Gesellschaft für Rheumatologie und Rehabilitation) working group for osteoarthritis and crystal arthropathies already published nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Since then, a multitude of literature has been published addressing this topic, what required an update. Methods First, the authors performed a hierarchical literature search to screen the meanwhile published literature. Also considering references of the first publication, the relevant literature was selected, and the 2015 recommendations were either kept as published, reformulated or newly produced. Finally, the evidence level and the level of agreement with each recommendation were added. Results Following this process, ten recommendations were generated instead of the initial nine. Like in the original publication, a colored icon presentation was provided to complement the written text. Conclusion The Austrian nutrition and lifestyle recommendations for patients with gout and hyperuricemia were updated incorporating the most recent relevant literature, serving as education material for patients and updated information for physicians.

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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

Cited by 52 publications

References 97 publications

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

Impact of cigarette smoking on rheumatoid arthritis-associated lung diseases: a retrospective case control study on clinical and radiological features and prognosis

2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia

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