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OBJECTIVES: To assess the effects of smoking on disease outcome in a large cohort of patients with early rheumatoid arthritis (RA). METHODS: Between 1996 and 2004, 1787 adult patients (disease duration ≤ 1 year) were included in the BARFOT early RA study in Sweden. Smoking status was recorded at inclusion in the study. Disease Activity Score using 28 joint counts (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ) score, rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (anti-CCP), general health (GH) and pain visual analogue scales (VAS), and drug treatment were registered at inclusion and at follow-up at 3, 6, and 12 months. European League Against Rheumatism (EULAR) response and remission criteria were applied at 3, 6, and 12 months. RESULTS: The proportion of patients who smoked at inclusion in the study fell from 29% in 1996 to 20% in 2004. There were no significant differences in disease activity at inclusion stratified according to smoking status. At 12 months offollow-up, 18% of current smokers at inclusion, 12% of previous smokers, and 11% of never smokers had high disease activity (DAS28 > 5.1, p = 0.005). Significantly fewer current smokers were in remission at 12 months (33%) compared to never smokers (36%) and previous smokers (42%) (p = 0.013). Current smoking at inclusion independently predicted poor EULAR response up to 12 months of follow-up. CONCLUSION: The present study gives some support to earlier data indicating that RA patients who smoke have a more active disease but further studies are needed to confirm this.

Study of the role of a functional polymorphism of MHC2TA in rheumatoid arthritis in three ethnically different populations.

OBJECTIVE—To assess the correlation between the presence of radiographically diagnosed osteophytes in the tibiofemoral joint (TFJ) and (1) magnetic resonance (MR) detected cartilage defects and meniscal lesions in the same joint and (2) knee pain. METHODS—Fifty nine people, 29 men and 30 women, with chronic knee pain (aged 41-58 years, mean 50 years) were examined with posteroanterior weightbearing radiograms in semiflexion of both TFJ. The presence and grade of marginal and central osteophytes were assessed. On the same day, an MR examination was performed of the signal knee with proton density and T2 weighted turbo spin-echo sequences on a 1.0 T imager. Cartilage defects and meniscal abnormalities in the TFJ were noted. The subjects were questioned for current knee pain for each knee. RESULTS—Marginal osteophytes had a sensitivity of 77%, specificity of 83%, and positive predictive value of 87% for MR detected cartilage defects in the TFJ and a sensitivity of 71%, specificity of 68%, and positive predictive value of 71% for meniscal abnormalities. A correlation (p