Rheumatoid Arthritis Patients’ Alcohol Consumption Habits Are Related to Pain Severity, Quality of Life

A study published in Arthritis & Rheumatology investigated the impact of alcohol consumption habits and health-related quality of life (QoL) in patients with rheumatoid arthritis.

“Multiple studies have found a relationship between alcohol consumption and disease activity in rheumatoid arthritis, although reverse causation has been suggested to explain the association,” wrote Lars Alfredsson and colleagues. For this analysis, they sought to specifically evaluate how alcohol consumption impacted arthritic disease activity and progression, and the subsequent impact on quality of life in patients with rheumatoid arthritis. So if you experience such similar situations like this and you are seeking for a professional help, Learn More Here!

Dr. Alfredsson and colleagues followed up with patients from the population-based, case-control EIRA (Epidemiological Investigation of Rheumatoid Arthritis) study, and follow-up questionnaires on environment and lifestyle factors were returned by 1,228 individuals with rheumatoid arthritis.

To assess disease-related parameters, participants completed several assessments at baseline and during follow-up: the 28-joint count Disease Activity Score (DAS28), Visual Analogue Scale (VAS) for pain, the Patient Global Assessment (PGA) and the Health Assessment Questionnaire (HAQ). At follow-up, patients also provided information regarding the currently number of swollen and tender joints and rated their fatigue on a scale from 0–100. QOL was assessed via the 36-Item Short-Form Health Survey.

Results were adjusted for patient demographics, disease duration, anti-citrullinated protein autoantibody (ACPA) status (positive/negative), rheumatoid factor (RF) status (positive/negative), physical activity, smoking, and body mass index. Patients were also stratified according to whether they had used disease-modifying anti-rheumatic drugs (DMARDs) during the first year of disease.

Alcohol Consumption in Arthritic Patients

Patients were separated into two groups: drinkers and non-drinkers. At the time of enrollment in the EIRA study as well as during follow-up for this study, participants provided information regarding current and previous alcohol consumption, particularly the weekly intake of alcohol in grams. Frequency of alcohol consumption was categorized as 0 (non-drinkers), 1 time per month, 2–4 times per month, 2–3 times per week, and 4 or more times per week.

At baseline (EIRA enrollment), the mean alcohol consumption was on the border of low and moderate consumption (52 g/week for women and 112 g/week for men), and alcohol use was correlated with ACPA negativity, RF status, and smoking. Non-drinkers reported higher scores for the DAS28 and HAQ measures and estimated their pain as more severe compared with the group of drinkers.

At 1-year follow-up, the frequency of consumption among the subgroup of alcohol drinkers was:

• 1 time per month: 23%
• 2–3 times per month: 43%
• 2–3 times per week: 29%
• >4 times per week: 5%

Patients who were non-drinkers at baseline and follow-up had more swollen/tender joints, greater pain and fatigue, and lower global health and health-related QoL scores at 1-year follow-up. Non-drinkers had a higher odds of scoring below the overall median for health-related QoL than drinkers (physical component odds ratio [OR]: 2.6; mental component OR: 2.1).

For patients who had ceased consuming alcohol after baseline, rates of pain and fatigue were higher and global health and QoL scores were lower than those who continued consuming alcohol. The ORs for having a health-related QoL lower than the median were 2.5 (physical component) and 2.7 (mental component) compared with drinkers. However, disease activity and disability levels were not different between drinkers who continued their alcohol use and those who stopped drinking.

The authors noted that treatment with DMARDs did not influence the results of the analysis. “The tendency to stop drinking alcohol after baseline was similar among those who started treatment with DMARD and those who did not,” they wrote.

In their discussion, the authors wrote, “Alcohol has dose-dependent immunomodulatory properties and has been shown to attenuate innate inflammatory responses in humans, which is compatible with our finding that alcohol consumption is related to rheumatoid arthritis disease activity and health-related quality of life.”

The study’s findings “pose a number of questions both concerning potential mechanisms behind the observations and concerning which advice to provide to patients and care givers,” they added.