TY - JOUR
T1 - Lifestyle Factors and Disease Activity Over Time in Early Axial Spondyloarthritis
T2 - The SPondyloArthritis Caught Early (SPACE) Cohort
AU - Exarchou, Sofia
AU - Turesson, Carl
AU - Lindström, Ulf
AU - Ramonda, Roberta
AU - Landewé, Robert B.
AU - Dagfinrud, Hanne
AU - van Gaalen, Floris
AU - van der Heijde, D. sirée
AU - Jacobsson, Lennart T.
N1 - Funding Information: SE’s work with the study was funded by the Swedish Rheumatism Association. 1S. Exarchou, MD, PhD, Rheumatology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; 2C. Turesson, MD, PhD, Rheumatology, Department of Clinical Sciences Malmö, Lund University, and Department of Rheumatology, Skåne University Hospital, Malmö, Sweden; 3U. Lindström, MD, PhD, L.T. Jacobsson, MD, PhD, Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4R. Ramonda, MD, PhD, Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy; 5R.B. Landewé, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, the Netherlands; 6H. Dagfinrud, PT, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; 7F. van Gaalen, MD, PhD, D. van der Heijde, MD, PhD, Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands. SE reports personal fees from Novartis and AbbVie outside the submitted work. CT reports personal fees from AbbVie, Pfizer, and Roche, and grants and personal fees from BMS, outside the submitted work. FvG reports grants from MSD, AbbVie, Stichting Vrienden van Sole Mio, UCB, and Pfizer, and grants and personal fees from Novartis, outside the submitted work. DvdH reports personal fees from AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, and UCB Pharma, and other fees from Imaging Rheumatology BV, outside the submitted work. LJ reports personal fees from Pfizer, AbbVie, Novartis, Eli Lilly, and Janssen, outside the submitted work. UL, RR, RL, and HD have no conflicts of interest relevant to this article. Address correspondence to Dr. S. Exarchou, Rheumatology, Department of Clinical Sciences Malmö, Lund University; Jan Waldenströms gata 1B, 205 02, Malmö, Sweden. Email: sofiaexar@hotmail.com. Accepted for publication August 13, 2021. Funding Information: The authors thank all patients and their rheumatologists for participation in the SPACE cohort. The authors would also like to thank the different participating centers in Italy (University of Padua, Padua), Norway (Diakonhjemmet Hospital, Oslo), the Netherlands (University of Leiden, Leiden; University of Amsterdam, Amsterdam; Groene Hart Hospital, Gouda), and Sweden (University of Lund, Malm?, and University of Gothenburg, Gothenburg on behalf of Swedish centers). The initial findings of the work presented in this manuscript were previously presented as a poster at the American College of Rheumatology 2019 conference in Atlanta and have been published in a conference abstract (Arthritis Rheumatol 2019; 71 Suppl 10). The published abstract is available at: https://acrabstracts.org/abstract/smoking-alcohol-intake-and-body-mass-index-in-prediction-of-disease-activity-over-time-in-early-axial-spondyloarthritis-results-from-the-spondyloarthritis-caught-early-space-cohort Publisher Copyright: © 2022 The Journal of Rheumatology
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Objective. Our aim was to study the importance of baseline BMI, smoking, and alcohol consumption (AC) for disease activity (DA) over 1 year in early axial spondyloarthritis (axSpA), stratified by sex. Methods. In the SPondyloArthritis Caught Early cohort (patients with chronic back pain onset at age < 45 yrs, with pain for ≥ 3 months and ≤ 2 yrs), the Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded at inclusion, 3, and 12 months. All patients included in the analysis had axSpA based on a high physician's level of confidence at baseline. Differences in ASDAS over 1 year by BMI (normal < 25 kg/m2, overweight 25-29.9 kg/m2, and obese ≥ 30 kg/m2), smoking history (never/previous/current), and AC (none, 0.1-2 units/week, 3-5 units/week, and ≥ 6 units/week) at baseline were estimated using mixed linear regression models. Results. There were 344 subjects (mean age of 30.3 yrs; 49.4% men). In women, obesity was associated with 0.60 (95% CI 0.28-0.91) higher ASDAS compared to normal BMI. In both sexes, AC tended to be associated with lower DA over 1 year, with a significant association only in women with the highest AC (mean difference of -0.55, 95% CI -1.05 to -0.04). Smoking was associated with higher ASDAS over 1 year compared to never smoking in both sexes, although the difference reached statistical significance only in female former smokers. Results were similar in multivariable analysis, adjusted for all lifestyle factors and other confounders. Conclusion. In early axSpA, BMI and smoking are associated with higher DA over 1 year, and AC with lower DA. The magnitude of the modest associations may differ between men and women.
AB - Objective. Our aim was to study the importance of baseline BMI, smoking, and alcohol consumption (AC) for disease activity (DA) over 1 year in early axial spondyloarthritis (axSpA), stratified by sex. Methods. In the SPondyloArthritis Caught Early cohort (patients with chronic back pain onset at age < 45 yrs, with pain for ≥ 3 months and ≤ 2 yrs), the Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded at inclusion, 3, and 12 months. All patients included in the analysis had axSpA based on a high physician's level of confidence at baseline. Differences in ASDAS over 1 year by BMI (normal < 25 kg/m2, overweight 25-29.9 kg/m2, and obese ≥ 30 kg/m2), smoking history (never/previous/current), and AC (none, 0.1-2 units/week, 3-5 units/week, and ≥ 6 units/week) at baseline were estimated using mixed linear regression models. Results. There were 344 subjects (mean age of 30.3 yrs; 49.4% men). In women, obesity was associated with 0.60 (95% CI 0.28-0.91) higher ASDAS compared to normal BMI. In both sexes, AC tended to be associated with lower DA over 1 year, with a significant association only in women with the highest AC (mean difference of -0.55, 95% CI -1.05 to -0.04). Smoking was associated with higher ASDAS over 1 year compared to never smoking in both sexes, although the difference reached statistical significance only in female former smokers. Results were similar in multivariable analysis, adjusted for all lifestyle factors and other confounders. Conclusion. In early axSpA, BMI and smoking are associated with higher DA over 1 year, and AC with lower DA. The magnitude of the modest associations may differ between men and women.
KW - alcohol consumption
KW - body mass index
KW - cigarette smoking
KW - lifestyle
KW - patient outcome assessment
KW - spondylarthritis
UR - http://www.scopus.com/inward/record.url?scp=85128161478&partnerID=8YFLogxK
U2 - https://doi.org/10.3899/jrheum.210046
DO - https://doi.org/10.3899/jrheum.210046
M3 - Article
C2 - 34470793
SN - 0315-162X
VL - 49
SP - 365
EP - 372
JO - Journal of rheumatology
JF - Journal of rheumatology
IS - 4
ER -