Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Cigarette Smoking Is Not a Risk Factor for Systemic Sclerosis.

Chaudhary3,  Prateek, Chen6,  Xing, Assassi3,  Shervin, Gorlova7,  Olga, Draeger5,  Hilda, Gonzalez8,  Emilio, McNearney1,  Terry

Indianapolis, IN
University of Texas Health Science Center at Houston, Houston, TX
University of Texas Health Science Center Houston, Houston, TX
University of Texas Health Science Center Houston
University of Texas Health Science Center San Antonio, San Antonio, TX
University of Texas MD Anderson Cancer Center, Houston, TX
University of Texas MD Anderson Health Science Center, Houston, TX
University of Texas Medical Branch at Galveston, Galveston, TX

Background:

Cigarette smoking has been well established as a risk factor for seropositive rheumatoid arthritis. Although smoking has been reported to worsen the vascular complications of systemic sclerosis (SSc), the role of cigarette exposure in susceptibility to SSc has not been previously reported. Our objective was to investigate the association of smoking with susceptibility to SSc in a large well-defined patient population.

Methods:

We conducted a review of 1,417 SSc patients enrolled in the Scleroderma Family Registry and DNA Repository and/or the GENISOS (Genes versus Environment in Scleroderma Outcomes Study) cohort. Smoking history was obtained from questionnaire data, chart review and, in some cases, via telephone interview with patients if sufficient information was not provided in medical records. Information extracted or asked included questions related to smoking status, duration and quantity.

SSc patients were subsequently categorized as never smokers, past smokers or current smokers. SSc patients with available smoking data were matched 2:1 by age, gender and ethnicity with a control group from the National Health and Nutrition Examination Survey (NHANES, 1999–2006). Furthermore, past smokers and current smokers were grouped as ever smokers in the comparative analysis.

Results:

The average age of 1417 enrolled patients was 53.6 years and most were female (88.1%). The majority of cases were White (78.3%) with an almost identical percentage of Latinos and Blacks (8.9% and 8.4%, respectively). Most patients had limited disease type (58.8%).

Smoking data were available in 759 (53.6%) patients. There was no significant difference in age, gender, ethnicity and SSc disease type between patients with or without available smoking data. The majority of patients had never smoked (57.4%). Patients with a smoking history classified themselves as past smokers or current smokers in 32.1% and 10.4% of cases, respectively. The average duration of smoking prior to the diagnosis of SSc in ever smokers was 18.3 years.

Overall, 42.6% (323/759) of SSc patients were ever smokers whereas 46.6% (709/1489) of matched controls in the NHANES survey had ever smoked. A Chi-Square analysis comparing cases and controls revealed that patients with SSc were less likely to be ever smokers than controls (p=0.04, OR: 0.83, 95% CI: 0.7–0.99).

Conclusion:

Unlike in rheumatoid arthritis, smoking does not confer a risk for development of SSc. In fact, these data would suggest a small protective effect of smoking. Further studies are needed to investigate whether cigarette smoking modulates auto-antibody expression or disease manifestations of SSc.

To cite this abstract, please use the following information:
Chaudhary, Prateek, Chen, Xing, Assassi, Shervin, Gorlova, Olga, Draeger, Hilda, Gonzalez, Emilio, et al; Cigarette Smoking Is Not a Risk Factor for Systemic Sclerosis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :562
DOI: 10.1002/art.28331

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