强化戒烟干预对风湿性关节炎患者戒烟和疾病活动的影响:随机对照试验
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
概括
对类风湿性关节炎患者进行的强化戒烟干预表明戒烟率较高,但没有改善临床反应. 需要进一步的研究,以平衡类风湿性关节炎治疗中的戒烟效益与疾病活性.
科学领域:
- 关节病学
- 公共卫生
- 药物成
背景情况:
- 风湿性关节炎 (RA) 患者受到吸烟的影响不成比例,这加剧了疾病的活性并降低了治疗效果.
- 戒烟对于治疗风湿性关节炎至关重要,但强化干预对戒烟和疾病活动的影响尚不完全理解.
研究的目的:
- 将6周的强化戒烟干预与RA患者的常规治疗进行比较.
- 在干预后三个月评估成功戒烟和欧洲反风湿联盟 (EULAR) 临床反应的共同主要结果.
主要方法:
- 这是一项多中心随机试验,涉及94名RA患者,病情活跃度低至中等.
- 干预组接受了5次单独的咨询和尼古丁替代疗法;对照组接受了通常的护理.
- 通过呼出的一氧化碳确认戒烟;通过DAS28-CRP改善定义的临床反应.
主要成果:
- 干预组的戒烟率为18%,对照组的戒烟率为4% (OR=4. 84).
- 与对照组 (20%) 相比,干预组的EULAR临床反应率较低.
- 疾病活动标志物 (DAS28-CRP,柔软关节计数,CRP) 优于对照组.
结论:
- 在RA患者中,强化戒烟干预显著增加了戒烟率.
- 然而,该干预措施并没有改善EULAR的临床反应,并且显示出对照组的疾病活性趋势.
- 这些发现表明需要仔细考虑戒烟努力与RA疾病管理之间的平衡.
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