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Obesity and smoking reduce chances of successful RA treatment, study finds

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People with early rheumatoid arthritis (RA) are more likely to achieve sustained remission if they have a healthy body weight and don´t smoke, a new study suggests.

Researchers at McGill University in Montreal, Canada, looked at the records of 1,008 people with early RA who had been enrolled into the Canadian Early Arthritis Cohort (CATCH) study.

The patients were followed for three years, with disease activity, patient-reported outcomes and medication assessed at each visit. Among males, just under half were overweight, one third obese, and one fifth smoked. Among females, just under one third were overweight, one third obese, and 15% smoked.

After adjusting for age, race, baseline disability, pain, and early use of methotrexate, the researchers found that smoking and excess weight had significant independent and combined effects on the likelihood of achieving sustained remission in men and women.

For example, a non-smoking male with a healthy BMI would have a 41% probability of achieving sustained remission within three years compared to only 15% for an obese male smoker. A non-smoking female with a healthy BMI would have a 27% probability of achieving sustained remission within three years compared to just 10% for an obese female smoker.

“Despite the high prevalence of excess body weight and smoking among RA patients, relatively little is known about whether and to what extent these modifiable lifestyle factors impact the likelihood of achieving sustained remission,” commented study investigator Dr Susan Bartlett from McGill University. “Our findings show that not smoking and a healthy body weight — lifestyle factors which can be modified by patients — can have a significant impact on becoming symptom-free.”

The findings were presented at the recent European League Against Rheumatism Annual Congress (EULAR 2016).