RESEARCH - Alcohol consumption is associated with decreased risk of RA

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Ann Rheum Dis. Published Online First: 5 June 2008. doi:10.1136/ard.2007.086314

Copyright © 2008 BMJ Publishing Group Ltd & European League Against

Rheumatism

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Extended Report

Alcohol consumption is associated with decreased risk of rheumatoid

arthritis; Results from two Scandinavian case-control studies

Henrik Källberg 1*, Søren sen 2, Camilla Bengtsson 3, Merete

Pedersen 4, Leonid Padyukov 1, Garred 5, Morten Frisch 4,

Wood Karlsson 6, Lars Klareskog 1 and Lars Alfredsson 1

1 Karolinska institutet, Sweden

2 Rigshospitalet, University of Copenhagen, Denmark

3 Karolinska Institutet, Sweden

4 Statens serum institut, Denmark

5 Rigshospitalet, Copenhagen, Denmark

6 Brigham and Women's Hospital, United States

Abstract

Objectives: The aim of the present study is to determine the

association between risk of rheumatoid arthritis (RA) and alcohol

consumption in combination with smoking and HLA-DRB1 shared epitope

(SE).

Methods: Data from two independent case-control studies of RA, the

Swedish EIRA (1204 cases and 871 controls) and the Danish CACORA- (444

cases and 533 controls) were used to estimate odds ratios (OR) of

developing RA for different amounts of alcohol consumed.

Results: Alcohol consumption was, more common in controls (p<0.05) and

dose-dependently associated with reduced risk of RA (p-trend<0.001) in

both studies. Among alcohol consumers, the quarter with highest

consumption had a decreased risk of RA in the order of 40-50% compared

with the half with the lowest consumption EIRA: (OR=0.5 (95%

confidence interval (CI) 0.4-0.6) and CACORA: OR=0.6 (95% CI

0.4-0.9)). For the subset of RA that is seropositive for antibodies to

citrullinated peptide antigens, alcohol consumption was observed to

reduce the risk the most in smokers carrying HLA-DRB1 SE alleles.

Conclusions: The observed inverse association between alcohol intake

and risk of RA and the recent demonstration of a preventive effect of

alcohol in experimental arthritis, indicates that alcohol may protect

against RA. This highlights the potential role of life-style in

determining the risk to develop RA, and emphasises the advice to stop

smoking, but not necessarily to abstain from alcohol in order to

diminish risk of RA. More generally, the evidence of potential RA

prevention, urges for additional studies on how this can be achieved.

http://ard.bmj.com/cgi/content/abstract/ard.2007.086314v1?papetoc

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