リウマチ性関節炎患者の禁煙と疾患活動に対する集中的な禁煙介入の効果:ランダム化制御試験
Bente Appel Esbensen1,2, Thordis Thomsen2,3, Ida Kristiane Roelsgaard1,4
1Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.
Rheumatology (Oxford, England)
|August 21, 2025
まとめ
リウマチ性関節炎患者の集中的な禁煙介入では,禁煙率が高くなったが,臨床反応は改善されなかった. リウマチ性関節炎の管理において,禁煙の効果と疾患活動のバランスを取るために,さらなる研究が必要である.
科学分野:
- リウマトロジ
- 公衆衛生
- 依存症 医学
背景:
- リウマチ性関節炎 (RA) の患者は,喫煙によって不釣り合いな影響を受け,病気の活動が悪化し,治療の有効性が低下します.
- 禁煙はRAの管理に不可欠ですが,RAにおける禁煙と疾患活動の両方に対する集中的な介入の影響は完全に理解されていません.
研究 の 目的:
- RA患者の通常の治療と比べて6週間の集中禁煙介入を比較する.
- 介入後3ヶ月で成功した禁煙とEULARの臨床反応を評価する.
主な方法:
- 低度から中度までの疾患のRA患者94人を対象とした多センターランダム化試験です.
- 介入グループは5回の個人カウンセリングとニコチン置換療法を受け,対照群は通常のケアを受けた.
- DAS28- CRPの改善によって定義された臨床反応.
主要な成果:
- 禁煙率は介入群では18%,対照群では4%であった (OR=4. 84).
- EULARの臨床反応率は,対照群 (20%) と比較して介入群 (12%) で低い.
- 病気の活動マーカー (DAS28-CRP,軟骨関節数,CRP) は対照群に優れていた.
結論:
- 集中的な禁煙介入により,RA患者の禁煙率が著しく上昇しました.
- しかし,介入はEULARの臨床反応を改善せず,対照群の病気の活動に有利な傾向を示した.
- 研究結果は,禁煙とRAの治療のバランスを 慎重に検討する必要があることを示唆しています.
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