{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:37:30Z","timestamp":1787071050839,"version":"build-2736575974"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Smoking may increase levels of pro-inflammatory cytokines, which is an important contributor to rheumatoid arthritis (RA) pathogenesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The aim of this study was to describe the characteristics of RA patients who were smokers compared with non-smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 849 RA patients who were smokers out of a large RA cohort of 10,364 patients (8.2%) were compared to 924 age-, sex-, and body mass index-matched RA patients who were non-smokers. Patients were subjected to full history-taking and clinical examination. Laboratory tests such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were measured. The disease activity score 28 (DAS28) and the health assessment questionnaire (HAQ) score were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age among smokers was 46.4 \u00b1 11.3 years, the male\u2013female ratio was 3:1, and the mean disease duration was 6.4 \u00b1 6.2 years. There was a significantly higher frequency of diabetes mellitus, hypertension, and metabolic syndrome in smokers compared to non-smokers (13.7%, 17.1%, and 9.2% vs. 8.4%, 12.9%, and 3.5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001, respectively), while hypothyroidism was more common in non-smokers (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03). Rheumatoid nodules (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03), oral ulcers (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), keratoconjunctivitis sicca (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.043), and neurological manifestations (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002) were significantly more common in smokers, but the DAS28 was lower (4.2 \u00b1 1.5 vs. 4.8 \u00b1 2.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). RA-related changes were significantly more common in female smokers than in males. On regression analysis, none of the differences found in the comparison between smokers and non-smokers remained significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Smoking in RA patients was found to be associated with a higher frequency of traditional comorbidities, rheumatoid nodules, oral ulcers, sicca complex, and neurological manifestations, but a lower disease activity. There is an obvious sex-driven pattern, with clinical alterations occurring more frequently in female smokers. Higher RF, anti-CCP, and double seropositivity are more observable in males and positive antinuclear antibody in females.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjmms.sjmms_746_24","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:02:20Z","timestamp":1745280140000},"page":"90-98","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics, Comorbidities, and Sex-related Differences Among Smoking and Non-smoking Patients with Rheumatoid Arthritis: A Matched Case\u2013control Study"],"prefix":"10.4103","volume":"13","author":[{"given":"Hanan M.","family":"Fathi","sequence":"first","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Tharwat","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"El Hadidi","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousra H.","family":"Abdel-Fattah","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa A.","family":"Amer","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira M.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad M.","family":"Elzokm","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan M.","family":"El-Saadany","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Elwan","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa","family":"Mosad","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah Ismail","family":"Nasef","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha E.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehad G.","family":"Elsehrawy","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan S.","family":"Al-Adle","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nermeen","family":"Samy","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman F.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enas A.","family":"Abdelaleem","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Taha","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faten","family":"Ismail","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa I.","family":"Selim","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada M.","family":"Gamal","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Elsaman","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Hammam","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, New Valley University, New Valley, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem H.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevin","family":"Hammam","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer A.","family":"Gheita","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"On Behalf of the Egyptian College of Rheumatology Rheumatoid Arthritis Study 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