THU0103 Disease Activity in Male Smokers Has A >10-Fold Amplified Effect on Radiographic Damage in Comparison with Female Non-Smokers in Ankylosing Spondylitis. (10th June 2014)

• Record Type: Journal Article
• Authors: Ramiro, S.; van Tubergen, A.; Landewé, R.; Stolwijk, C.; Dougados, M.; van den Bosch, F.; van der Heijde, D.
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Supplement 2(2014)
• Page Start: 212
• Page End: 213
• Publication Date: 2014-06-10
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-eular.1958
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: We have shown that disease activity has an effect on radiographic progression over the long-term and that gender and symptom duration are effect modifiers. Smoking has been shown to predict radiographic progression. Objectives: To investigate whether smoking influenced this longitudinal relationship between disease activity and radiographic damage. Methods: Patients from the Outcome in AS International Study (OASIS) were followed-up for 12 years, with biannual clinical and radiographic assessments. Two readers independently scored the x-rays according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and scores were averaged. Disease activity was assessed by the ASDAS-CRP. The relationship between ASDAS and radiographic damage was investigated using generalized estimating equations, with auto-regressive (i.e. adjusted for the 2-year previous mSASSS) models with a 2-year time-lag. Interactions were tested with baseline smoking status and if significant, analyses were repeated in strata. Results: A total of 127 patients were included (71% males, mean (SD) age 41 (12) years, mean symptom duration 18 (11) years and 82% HLA-B27 positive). Smoking status modified the relationship between disease activity and radiographic damage significantly (p<0.001), and this effect extended to other strata: males (p=0.002) and patients with shorter symptom duration (<18y) (p=0.009); Overall, an increase in one ASDAS-unit led to an increase in 0.72 mSASSS-units per 2 years. In smokers, this value reached 1.94 mSASSS-units and in male smokers 2.15 mSASSS-units (Table ). Comparing the magnitude of the effect of ASDAS on mSASSS in smokers vs non-smokers, smokers had a 5.5 fold amplified effect, whereas male smokers had a 13.4 fold amplified effect compared to female non-smokers. Smokers with short symptom duration had a 8.1-fold amplified effect compared to non-smokers with long symptom duration (Figure ). Conclusions: Smoking amplifies the effect of disease activity on radiographic damage (5-fold). This effect is further amplified in male smokers (13.4-fold) in comparison with female non-smokers. Disclosure of Interest: : None declared DOI: 10.1136/annrheumdis-2014-eular.1958