Lifestyle factors, comorbidities linked to difficult-to-treat rheumatoid arthritis

Difficult-to-treat rheumatoid arthritis is associated with smoking, obesity, fibromyalgia, and depression, according to the results of a meta-analysis.

Researchers searched multiple online databases for observational studies in which predefined lifestyle factors and comorbidities were examined in relation to difficult-to-treat rheumatoid arthritis, as defined according to the European Alliance of Associations for Rheumatology.

A total of 21 studies involving 22,968 patients with rheumatoid arthritis, of which 2,783 had difficult-to-treat rheumatoid arthritis, met the eligibility criteria and were included in the meta-analysis.

Pooled data showed marked associations between difficult-to-treat rheumatoid arthritis and smoking history (odds ratio [OR], 1.16, 95 percent confidence interval [CI], 1.01–1.34; I²=23 percent), obesity (OR, 1.38, 95 percent CI, 1.11–1.72; I²=0 percent), fibromyalgia (OR, 2.20, 95 percent CI, 1.64–2.96; I²=43 percent), and depression (OR, 1.74, 95 percent CI, 1.39–2.18; I²=0 percent).

There were no significant associations observed for current smoking, anxiety, and BMI as a continuous measure.

Analyses of socioeconomic status, osteoarthritis, and alcohol consumption were limited by few available studies.

In the assessment of risk of bias, most studies were found to be of high quality, with no significant publication bias detected.

The present data highlight the need for integrated management approaches that address both inflammatory pathways and risk factors in rheumatoid arthritis treatment strategies.