Quitting Smoking Improves Ankylosing Spondylitis Symptoms

Patients with ankylosing spondylitis (AS) could benefit from smoking cessation, according to a study.

“Previous studies in AS patients have found smoking to be associated with increased disease activity, poorer quality of life, and increased functional disability,” wrote the researchers. “One study demonstrated that smoking causes progression of structural damage in axial spondyloarthritis, another study established its association with not only progression but also pathogenesis. Smoking intensity can also be a major risk factor for AS.” In this study, the researchers analyzed the impact of quitting smoking on patients’ disease activity, psychological state, physical mobility, lung function, and quality of life.

The longitudinal, single-blind, controlled, observational study study appeared in the October issue of JCR: Journal of Clinical Rheumatology.

A total of 92 patients were evaluated using a pulmonary function test, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index, chest expansion, Short-Form 36 (SF-36), and Ankylosing Spondylitis Quality of Life (ASQoL). Patients were stratified by smoking status (smokers, group 1, n = 54; nonsmokers, group 2, n = 38). The smoking group was further stratified by those who did (group 1a, n = 17) and did not (group 1b, n = 37) quit smoking. Baseline and six-month data were compared for groups 1a and 1b.

Smoking Cessation Improves Symptoms, Quality of Life

After six months, no significant differences were observed between groups 1a and 1b, except BASDAI, which was significantly lower in group 1a than 1b (P = 0.02). From baseline to six months in group 1a, significant improvements were observed in BASDAI (P = 0.001), BASFI (P = 0.001), chest expansion (P = 0.001), and ASQoL (P = 0.003), as well as subparameters physical function (P = 0.015), physical role strength (P = 0.05), power/live/vitality (P = 0.025), social functioning (P = 0.039), pain (P = 0.036), and general health perception (P = 0.05) of SF-36. Forced expiratory volume in the first second and forced vital capacity also significantly improved at the six-month mark (P = 0.003 and P = 0.007, respectively).

“In conclusion, we observed significant improvements in disease activity, physical mobility, and quality of life, as well as improvement in lung functions in AS patients who quit smoking,” concluded the study authors. “Based on the results of this study, smoking cessation in AS patients helps to improve treatment outcomes.”