ROME — Alcohol use was linked with a reduced risk for having several forms of arthritis in a case control study of about 1,000 arthritis patients and nearly 6,000 controls.
Patients with newly diagnosed arthritis—rheumatoid, psoriatic, or reactive arthritis, spondyloarthritis, or osteoarthritis had a significantly reduced prevalence of alcohol use, compared with a control population of adults who were free of arthritis.
Dr. Diane van der Woude
In an analysis that controlled for age, gender, body mass index, and smoking, patients with arthritis had a roughly 70% reduced relative rate of being alcohol consumers, suggesting a protective effect from alcohol against a variety of arthritis types, Dr. Diane van der Woude said at the annual European Congress of Rheumatology.
However, she also gave an alternative, equally plausible explanation of the finding: reduced alcohol use was not the cause but the result of the arthritis. People with arthritis "do not feel well and so may be less physically capable of drinking, such as going to a pub, or they may not drink because they are on pain-killing medications," said Dr. van der Woude, of the rheumatology department of Leiden (the Netherlands) University Medical Center.
The new evidence confirms and expands a finding from a Swedish case control study published last year that found a link between a reduced prevalence of alcohol consumption and rheumatoid arthritis (Ann. Rheum. Dis. 2009;68:222-7). The Swedish study also showed a dose-response relationship, where people with the highest level of alcohol use had the lowest prevalence of rheumatoid arthritis. In contrast, Dr. van der Woude and her associates found no link between arthritis and quantity of alcohol in their analysis of the impact of amount of alcohol consumed. The significant relationship only held for whether or not the patients drank any alcohol, regardless of amount.
Dr. van der Woude’s study expanded the 2009 Swedish finding to arthritis types beyond rheumatoid.
Her study used 997 patients with arthritis of less than 2 years’ duration enrolled in the Leiden Early Arthritis Clinic, and 5,877 people with no history of arthritis from the Leiden area. The arthritis cohort included 651 patients with rheumatoid arthritis, 130 with psoriatic arthritis, 76 with spondyloarthritis, 73 with osteoarthritis, and 67 with reactive arthritis. When asked whether they drank any alcohol, 53%-68% of the arthritis patients said yes (the rate varied by arthritis type), compared with 83% of the controls. These are "large differences," Dr. van der Woude said in an interview.
The observation that alcohol use was low in patients with osteoarthritis reduced the likelihood that the link can be explained by alcohol having a protective, anti-inflammatory effect. In fact, low alcohol use among people with arthritis increased the possibility that the explanation is that arthritis reduced alcohol consumption. Dr. van der Woude plans to test this possibility by looking at other types of patients with chronic illness, such as inflammatory bowel disease, to see if a similar link exists. She also plans to study arthritis patients on successful treatment who have low disease activity to see whether their alcohol use is closer to control levels.
Dr. van der Woude said that she and her associates had no disclosures.