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Does smoking affect level of seropositivity in RA? A post-HOC global and inter-country analysis of COMORA cohort

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Abstract

To study the association of smoking status and the level of seropositivity in RA patients from COMORA Cohort. A post hoc analysis of COMORA database included 3439 RA patients was performed. Current smokers or recently quitted (< 3 years) were initially compared to those who never smoked or stopped > 3 years (Group I vs. II) regarding their seropositivity status (high positive, low positive and negative) for Rheumatoid Factor (RF) or Anti-citrullinated antibodies (ACPA). A further comparison was made between current smokers (Group III) and never smoked patients (Group IV). Analysis was also done on the individual country level for the 17 countries included in the COMORA study. Out of 3439 RA patients, 705 (20.5%) were smokers (group I), and 2734 (79.5%) were non-smokers (group II). Significantly more patients in group I, 442 (62.7%), had high levels of seropositivity than those in group II, 1556 (56.9%), [P = 0.006, OR 1.27 (95% CI, 1.07–1.5)]. More current smoker patients (group III—286 out of 456 “62.7%”) had high levels of seropositivity than never smoked patients (group IV—1236 out of 2191 “56.4%”), with significant difference [P = 0.013, OR 1.3 (95% CI, 1.06–1.6)]. In 11 countries, higher proportions of patients with high level of seropositivity in group I was found, with statistical significance in four countries. Smoking was associated with higher level of seropositivity in patients with RA in this post hoc analysis, both on a global level and in certain individual countries. As smoking is a modifiable risk factor, studying the effects of quitting smoking on level of seropositivity and other disease parameters is warranted.

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Acknowledgements

The authors thank all patients and investigators who participated in the COMORA study and all co-authors of the original COMORA manuscript.

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Authors and Affiliations

  1. Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Bassel Elzorkany, Abir Mokbel & Sherif M. Gamal

  2. Health Research Methodology Department, McMaster University, Hamilton, Canada

    Abir Mokbel

  3. Faculty of Medicine, Laboratory of Clinical Research and Epidemiology, Mohammed V University, Rabat, Morocco

    Ihsane Hmamouchi

  4. Medicine Faculty, Paris-Descartes University, Paris, France

    Maxime Dougados

  5. Rheumatology B Department, APHP, Cochin Hospital, Paris, France

    Maxime Dougados

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  1. Bassel Elzorkany
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  2. Abir Mokbel
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  4. Ihsane Hmamouchi
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  5. Maxime Dougados
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Correspondence to Sherif M. Gamal.

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Elzorkany, B., Mokbel, A., Gamal, S.M. et al. Does smoking affect level of seropositivity in RA? A post-HOC global and inter-country analysis of COMORA cohort. Rheumatol Int 41, 699–705 (2021). https://doi.org/10.1007/s00296-021-04791-w

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  • DOI: https://doi.org/10.1007/s00296-021-04791-w

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