Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Universidad Nacional Autónoma de México, Faculty of Medicine, Mexico City, Mexico.
Clin Rheumatol. 2011 Dec;30(12):1589-93. doi: 10.1007/s10067-011-1775-5. Epub 2011 May 24.
The purpose of this study is to determine factors associated with a non-ACR 50 response at 6 months of follow-up, in a cohort of patients with early rheumatoid arthritis (RA). Early RA patients (symptom duration <1 year), treated with the same combination treatment (methotrexate and sulfasalazine), were included. Demographic characteristics of the patients including current smoker status (defined as a patient that smokes at least one cigarette per day), years of formal education, a 28-joint count for swelling and tenderness were registered. A basal HAQ questionnaire, visual scales for global assessment, and pain were answered by all patients, and a CDAI basal score was calculated. The ACR 50 response was determined at 6 months follow-up. Multivariable logistic regression analysis was used to calculate adjusted ORs. Two hundred twenty-five patients were evaluated, but only 144 had a complete follow-up, 43% of the latter did not reach an ACR 50 response. The only factor associated with this outcome was current smoking (OR 3.58, P < 0.008, 95% CI 1.23-11.22). Low level of formal education (≤6 years) had a tendency towards a statistical difference (P < 0.08). After controlling with low level of formal education, sex, age in years, and CDAI baseline value with multivariable logistic regression analysis, current smoking status had an adjusted OR of 3.91 (P < 0.009, 95% CI 1.41-10.81). Smoking is associated with a non-ACR 50 response in early rheumatoid arthritis in patients treated with a combination therapy with methotrexate and sulfasalazine.
本研究旨在确定与早期类风湿关节炎（RA）患者 6 个月随访时未达到 ACR50 反应相关的因素。纳入了接受相同联合治疗（甲氨蝶呤和柳氮磺胺吡啶）的早期 RA 患者。登记了患者的人口统计学特征，包括当前吸烟状况（定义为每天至少吸一支烟的患者）、受教育年限、28 个关节肿胀和压痛计数。所有患者均回答了基线 HAQ 问卷、整体评估视觉量表和疼痛问题，并计算了 CDAI 基线评分。在 6 个月随访时确定 ACR50 反应。使用多变量逻辑回归分析计算调整后的 OR。评估了 225 名患者，但只有 144 名患者完成了完整随访，其中 43%的患者未达到 ACR50 反应。唯一与该结果相关的因素是当前吸烟（OR 3.58，P<0.008，95%CI 1.23-11.22）。受教育程度较低（≤6 年）有统计学差异的趋势（P<0.08）。在校正低受教育程度、性别、年龄、CDAI 基线值后，通过多变量逻辑回归分析，当前吸烟状况的调整 OR 为 3.91（P<0.009，95%CI 1.41-10.81）。在接受甲氨蝶呤和柳氮磺胺吡啶联合治疗的早期类风湿关节炎患者中，吸烟与未达到 ACR50 反应相关。
