Dr. Gabay has received consulting fees, speaking fees, and/or honoraria from Abbott, Essex, Wyeth, Roche, and Bristol-Myers Squibb (less than $10,000 each).
Rheumatoid Arthritis Clinical Studies
The effect of alcohol on radiographic progression in rheumatoid arthritis
Article first published online: 8 MAR 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 62, Issue 5, pages 1265–1272, May 2010
How to Cite
Nissen, M. J., Gabay, C., Scherer, A., Finckh, A. and Swiss Clinical Quality Management Project in Rheumatoid Arthritis (2010), The effect of alcohol on radiographic progression in rheumatoid arthritis. Arthritis & Rheumatism, 62: 1265–1272. doi: 10.1002/art.27388
- Issue published online: 29 APR 2010
- Article first published online: 8 MAR 2010
- Accepted manuscript online: 8 MAR 2010 12:00AM EST
- Manuscript Accepted: 26 JAN 2010
- Manuscript Received: 29 OCT 2009
- Swiss National Science Foundation. Grant Numbers: 320000-119728, 3200B0-120639
- Bristol-Myers Squibb
- Essex Chemie
- Swiss health authorities
Alcohol consumption reduces the risk of development of rheumatoid arthritis (RA) and significantly attenuates the development of erosive arthritis in animal models. It remains unknown whether alcohol consumption influences joint damage progression in RA. This study was undertaken to compare the rates of radiographic damage progression in alcohol drinkers and nondrinkers in a large prospective cohort of patients with RA.
All patients in the population-based Swiss Clinical Quality Management in RA registry database with at least 2 sequential radiographs were included. Joint erosions were assessed in 38 joints in the hands and feet using a validated scoring method. The rate of progression of erosions was analyzed using multivariate regression models for longitudinal data and was adjusted for potential confounders.
The study included 2,908 patients with RA with a mean of 4 sequential radiographs and 3.9 years of followup. A trend toward reduced radiographic progression existed in drinkers compared with nondrinkers, with a mean rate of erosive progression of 0.99% (95% confidence interval [95% CI] 0.89–1.09) and 1.13% (95% CI 1.01–1.26) at 1 year, respectively. Alcohol consumption displayed a J-shaped dose-response effect, with a more favorable evolution in occasional consumers (P = 0.01) and daily consumers (P = 0.001) as compared with nondrinkers, while heavy drinkers demonstrated worse radiographic evolution (P = 0.0001). We found significant effect modification by sex, with male drinkers displaying significantly less erosive progression compared with male nondrinkers (mean 0.86% [95% CI 0.70–1.03] versus 1.35% [95% CI 1.02–1.67]; P = 0.007).
Our findings indicate a trend toward reduced radiographic progression in alcohol drinkers compared with nondrinkers, specifically in occasional and daily alcohol consumers. In particular, male patients with RA who consume alcohol demonstrate less radiographic progression than do male nondrinkers.