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Research Summary

Moderate Drinkers Are at Lower Risk of Rheumatoid Arthritis

The goal of this study was to determine the association between risk of rheumatoid arthritis (RA) and alcohol consumption in combination with smoking and the HLA-DRB1 shared epitope (SE). Data from 2 independent case-control studies, the Swedish Epidemiological Investigation of Rheumatoid Arthritis (1204 cases and 871 controls) and the Danish Case-Control Study on Rheumatoid Arthritis (444 cases and 533 controls), were used to estimate odds ratios of developing RA based on the amount of alcohol consumed.

  • Alcohol consumption was dose-dependently associated with a reduced risk of RA. Among alcohol consumers, the quarter with the highest consumption (4.9 or more drinks* per week in one study and 12 or more drinks per week in the other) had a decreased risk of RA of 40–50% compared with the half with the lowest consumption.
  • For the subset of RA characterized by the presence of antibodies to citrullinated peptide antigens, alcohol consumption reduced the risk most prominently in smokers carrying HLA-DRB1 SE alleles.
*1 drink = 16 g alcohol for both studies.

Comments:

Although the main findings of this study suggest alcohol may protect against RA, some issues are worth commenting on. This was a cross-sectional analysis. The benefits attributed to alcohol were especially prevalent among people with RA who had relatively long disease duration, raising the possibility of reverse causality: i.e., patients developing RA may stop drinking after they get the disease; hence, they could be classified as "nondrinkers." Nevertheless, these results provide additional evidence that RA may occur less frequently among people who drink. It will be important to confirm these findings in prospective studies. R. Curtis Ellison, MD

Reference:

Källberg H, Jacobsen S, Bengtsson C, et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case-control studies. Ann Rheum Dis. 2009;68(2):222–227.

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