Patients with ankylosing spondylitis (AS) who smoke are twice as likely to have cumulative spinal structural damage, according to preliminary results of a systematic review study conducted by researchers at the Izmir Katip Celebi University, Turkey.
This finding was the subject of an oral presentation titled “The Role of Smoking in the Development and Progression of Structural Damage in Patients with Ankylosing Spondylitis: the Preliminary Results of a Systematic Review and Meta-Analysis,” presented at the 2017 Annual European Congress of Rheumatology (EULAR), in Madrid, Spain.
The majority of patients with AS carry a genetic marker called HLA-B27, which has been recognized as a major cause of this medical condition. However, the trigger of AS is not restricted to genetics, as some AS patients do not carry this biomarker.
Previous studies have suggested that smoking can take part in AS susceptibility, being associated with an increased incidence of the disease. Smoking also has been implicated in AS severity. Researchers have therefore suggested that smoking can have a negative impact on disease activity and AS patients’ functional ability.
To understand the potential association between smoking and increased progression of spinal damage observed on radiographic evaluation of AS patients, researchers conducted a review analysis of available studies in the topic. A total of eight studies investigating the association between smoking and cumulative spinal structural damage or radiographic progression were included in the analysis.
Preliminary results obtained from the pooled data of these studies demonstrated a significant association between smoking and cumulative spinal structural damage. Indeed, smoking was associated with twice the chance of cumulative spinal damage in AS patients.
“Smoking constitutes a major risk factor not only for disease susceptibility but also disease severity in patients with AS,” professor Servet Akar, MD, lead author of the study, said in a press release. “Rheumatologists should work hard to encourage their AS patients to quit smoking as this could have a major impact on future quality of life.”
The association between smoking and AS progression was assessed by radiographic detection of syndesmophytes, which are bony growths in the intervertebral joints. Both new formations and increased growth of already-present syndesmophytes are still under evaluation by the research team.
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