Moderate alcohol use may protect against rheumatoid arthritis

Last Updated: 2008-06-05 13:45:14 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Moderate alcohol consumption may lower the risk of developing rheumatoid arthritis, according to findings from two Scandinavian case-control studies posted online on June 5 by the Annals of the Rheumatic Diseases.

Evidence from animal studies indicates that alcohol intake may reduce the incidence and severity of experimental arthritis by downregulating proinflammatory cytokines, Dr. Henrik Kallberg, at Karolinska Institute in Stockholm, and his associates explain.

For their current report, Dr. Kallberg’s group evaluated data from population-based studies in Denmark (444 cases and 523 controls) and Sweden (1204 cases and 871 controls) to evaluate the influence of alcohol, smoking, and the presence of HLA-DRB1 SE alleles.

In both studies, mean number of alcoholic drinks per week was lower in the case groups (2.9 vs 4.1, p < 0.001 in the Swedish study; 6.6 vs 9.0, p = 0.003 in the Danish study). The risk of rheumatoid arthritis was reduced by about 40% to 50% in the quartile of subjects with the highest consumption compared with those with the lowest consumption.

The investigators further explored gene-environment interactions among subjects positive for antibodies to citrullinated peptide antigens (ACPAs), since smoking is known to influence only ACPA-positive rheumatoid arthritis.

In both studies, the risk reduction with alcohol consumption was more pronounced among ever-smokers than among never-smokers, and in carriers of HLA-DRB1 SE alleles than among noncarriers. The greatest effect was observed among smokers carrying one or two HLA-DRB1 SE alleles.

"The main message remains that cessation of smoking is the most effective way to diminish the risk of rheumatoid arthritis, irrespective of genetic constitution, but that this recommendation should not necessarily be combined with a recommendation to stop moderate alcohol consumption." Dr. Kallberg and his associates conclude.

Ann Rheum Dis 2008.