Smoking, body mass index, disease activity, and the risk of rapid radiographic progression in patients with early rheumatoid arthritis

Table 3 Baseline predictors of radiographic progression with change in SHS above the median (i.e. > 12) up to 5 years

	Crude		Adjusted^a
	OR	95% CI	OR	95% CI
Demographics and anthropometrics
Male sex	1.25	(0.64–2.46)	0.96	(0.46–1.98)
Age (per SD)^b	1.18	(0.86–1.62)	1.23	(0.88–1.74)
Time to first DMARD (per SD)^b	1.08	(0.80–1.45)	1.06	(0.74–1.53)
BMI (per SD)^b	0.93	(0.67–1.29)	0.84	(0.59–1.19)
Normal BMI^c (reference)	1.00		1.00
Obese^c	0.98	(0.35–2.74)	0.79	(0.26–2.37)
Obese or overweight^c	0.71	(0.37–1.34)	0.67	(0.33–1.34)
Overweight^c	0.64	(0.33–1.27)	0.64	(0.31–1.33)
Smoking habits
Never smoker (reference)	1.00		1.00
Current smoker	2.16	(0.99–4.73)	1.82	(0.80–4.16)
Ever smoker	1.83	(0.93–3.57)	1.55	(0.76–3.16)
Previous smoker	1.56	(0.72–3.37)	1.39	(0.61–3.17)
Baseline disease parameters
RF positivity	3.18	(1.60–6.34)	NA	NA
Anti-CCP positivity	2.47	(1.24–4.94)	1.41	(0.64–3.13)
Erosions present^d	4.00	(1.59–10.06)	NA	NA
DAS28 (per SD)^b	1.07	(0.78–1.47)	1.06	(0.75–1.49)
Disease activity^c
Low/moderate (reference)	1.00		1.00
High	1.44	(0.76–2.75)	1.44	(0.72–2.86)
HAQ (per SD)^b	0.99	(0.73–1.34)	1.08	(0.78–1.49)
ESR (per SD)^b	1.73	(1.23–2.44)	1.57	(1.10–2.24)
CRP below median (reference)	1.00		1.00
CRP above median (> 9 mg/l)	2.07	(1.11–3.88)	1.64	(0.84–3.19)
Swollen joint count (per SD)^b	0.94	(0.68–1.30)	0.93	(0.66–1.32)
Tender joint count (per SD)^b	0.61	(0.42–0.89)	0.66	(0.45–0.98)
Patient’s global assessment (VAS; per SD)^b	1.16	(0.84–1.60)	1.13	(0.80–1.60)
Pain (VAS; per SD)^b	0.99	(0.72–1.36)	1.03	(0.73–1.44)

OR odds ratio, CI confidence interval, SD standard deviation, DMARD disease-modifying antirheumatic drug, BMI body mass index, NA not applicable, RF rheumatoid factor, anti-CCP antibodies to cyclic citrullinated peptides, DAS28 Disease Activity Score of 28 joints, HAQ Health Assessment Questionnaire, ESR erythrocyte sedimentation rate, CRP C-reactive protein, VAS visual analogue scale
^aAdjusted for RF and presence of erosions
^bSD: age 15 years; time to first DMARD 5.8 months; BMI 4.0 kg/m²; DAS28 1.4; HAQ 0.64; ESR 26 mm/h; swollen joint count 4.9; tender joint count 5.8; patient’s global assessment 26; pain 26
^cFor definitions see Table 1
^dBy standard radiographic evaluation, independent of modified Sharp–van der Heijde scoring

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